Americans tend to be pretty savvy about advertising. Put a box around claims, annotate them with the words “paid advertisement” or “sponsored content” and most people approach those claims warily. Unfortunately, the same people who are dubious about advertising claims are remarkably gullible when it comes to quackery.

That’s the bad news. The good news is that it is surprisingly easy to tell quackery apart from real medical information. Quack claims are typically decorated with red flags … if you know what to look for. What follows is a list of some of those red flags.

1. The secret knowledge flag: When someone implies they are sharing secret medical knowledge with you, run in the opposite direction. There is no such thing as secret medical knowledge. In an age where there are literally thousands of competing medical journals, tremendous pressure on researchers to publish papers, and instantaneous dissemination of results on the Internet, nothing about medicine could possibly be secret.

2. The giant conspiracy flag: In the entire history of modern medicine, there has NEVER been a conspiracy to hide lifesaving information among professionals. Sure, an individual company may hide information in order to get a jump on competitors, or to deny harmful effects of their products, but there can never be a large conspiracy because every aspect of the healthcare industry is filled with competitors. Vast conspiracies, encompassing doctors, scientists and public health officials exist only in the minds of quacks.

3. The flattery flag: Quacks invariably try to flatter potential customers by implying that those customers are uncommonly smart, insightful and wary. They portray non-believers as “sheeple” who are content to accept authority figures rather than think for themselves. A real medical professional does not need to flatter you. He or she knows what is true and what isn’t and shares that information whether it makes you happy or is the last thing you want to hear. You can believe it or not.

4. The toxin flag: I’ve written before that toxins are the new evil humors. Toxins serve the same explanatory purpose as evil humours did in the Middle Ages. They are invisible, but all around us. They constantly threaten people, often people who unaware of their very existence. They are no longer viewed as evil in themselves, but it is axiomatic that they have be released into our environment by “evil” corporations. There’s just one problem. “Toxins” are a figment of the imagination, in the exact same way that evil humours and miasmas were figments of the imagination.

5. The “brilliant heretic” flag: The quack often has no training in the relevant discipline, be it obstetrics, immunology or cancer care? No problem. A pervasive theme in quackery is the notion of the brilliant heretic. Believers argue that science is transformed by brilliant heretics whose fabulous theories are initially rejected, but ultimately accepted as the new orthodoxy. The conceit rests on the notion that revolutionary scientific ideas are dreamed up by mavericks, but nothing could be further from the truth. Revolutionary scientific ideas are not dreamed up; they are the inevitable result of massive data collection. Galileo did not dream up the idea of a sun-centered solar system. He collected data with his new telescope, data never before available, and the sun-centered solar system was the only theory consistent with the data he had collected.

6. The “quantum” flag: Quacks love to baffle followers with bullshit, hence the invocation of esoteric scientific theories that they don’t understand. Quantum mechanics and chaos theory are two incredibly abstruse scientific disciplines, heavy on advanced math. If you don’t have a degree in either one, you aren’t qualified to pontificate on them. The same thing applies to new, imperfectly understood areas of science like epigenetics or the microbiome. Both are genuine scientific concepts, but we are in the earliest stages of elucidating them. There is real danger in insisting that they have current practical implications. We should learn from the terrible mistakes that were made when radiation was first discovered and and radioactive compounds were added to everything from water to make up under the false belief that radiation could prevent everything from aging to death.

There is a saying in science that “extraordinary claims require extraordinary evidence.” Quack claims are typically extraordinary, but quacks don’t offer evidence, they raise some or all of the six red flags in an attempt to trick you into buying what they are selling, and they are invariably selling something. When you see one of these red flags, you can be virtually certain that you are in the presence of quackery. Run, don’t walk, in the opposite direction.

Can’t get over how this discussion has turned into a wrangle about qualifications.
Not that there’s anything wrong with qualifications. I’m not against them.
However, the article is really common sense. I don’t have any qualifications, – but we peasants are allowed to read widely, and have an opinion. Sometimes, I suspect that generalists have more common sense.

FedUpWithIgnorantPeople

#1 way to avoid quackery: go to, read from, and listen to an actual licensed physician.

pixel fairy

this is known as the labcoat fallacy. its used in marketing all the time! only by peer review and application of scientific method can we come closer to truth. that means questioning and re questioning periodically.

remember, licensed physicians dont always keep up on research, and can be bamboozled just like the rest of us. when was the last time your doctor told you avoid eating eggs because the saturated fat would clog your arteries?

Stacy48918

So is there a comparable dreads, candles and a comfy couch fallacy for home midwives?

MANY homebirthers trust their midwives implicitly just because she “listens to me at my 30 minute appointments”. Never mind that she ignores all the research.

One doesn’t need to keep up with every paper and publication. There are these things called consensus statements.

When was the last time a midwife told a woman to avoid antibiotics and just use garlic and hibiclens?

pixel fairy

im not implying doctors dont know what they’re doing.

im just saying they’re not immune. thats how science advances. when you dont have time to analyze, its obviously a better bet to go with the one with a better science education and less is superstitious in the area of knowledge in question. i dont care if a mechanical engineer im working with happens to be her community witch doctor, but im not going to her for any advice if my leg started hurting.

in the example above, if my doctor told me to start avoiding saturated fats, i would dismiss that compared to the research i have done on the subject. (im an ex chemistry major) had i not done said research, then id probably start skipping the eggs at breakfast, because that makes more sense.

and yea, what your refering to is a variant of the labcoat fallacy. but this one is easy. look up the death and complication rates of midwives and compare to in hospital births. preferably the hospital your going to and/or some local ones. if nothing else, maybe you’ll find out the one across town has a better record. if you cant find that data, then the task is harder.

and, yes, im fully aware of consensus statements

Young CC Prof

Are doctors always right? No.

However, your doctor who has examined and talked to you is a much better bet than most other sources. If you doubt your doctor, get another opinion, possibly from an expert in the field.

The death rates of home birth midwives, oh, heavens I have spent so many hours with my fingers in those, and they are hideous. Beyond hideous. Perfectly normal full-term babies dead of their recklessness.

Worst of all, I know that however I try to count them, I’m still under-counting.

By the way, no doctor has ever told me not to eat eggs.

Trixie

Being an “ex chemistry major” doesn’t really even put you in the top 50% in terms of relevant higher education levels achieved by regular commenters on this blog.

The Bofa, Being of the Sofa

What is an “ex-chemistry major” anyway? Apparently, the person was a chemistry major at one point and then switched?

If you finished a chemistry degree, that would not make you an ex-chemistry major.

Trixie

At my college, there were tons of ex-chemistry and ex-biology majors. Close to half of freshmen entered with the intent to be pre-med, and by the end of the year, only a fraction of those could actually hack it.

The Bofa, Being of the Sofa

Yeah, but in that case, “ex-chemistry major” is not a good indicator of your great chemistry knowledge. You don’t say, “I know about chemistry because I failed out of the degree program”

In the US, the number of chemistry majors that start and finish is more like 75%. Bio is pretty much the same. Moreover, many of those who change from chem go to bio, and vice versa. And most of the others go to computer science.

Trixie

I’m agreeing with you.
At our school, a lot of them went into geoscience.

pixel fairy

also, i shouldnt have to say this, but, just because a licensed physician is promoting something, doesnt make it good. thats what i meant about marketing.

Recommend them in certain situations where they might be appropriate? Not unlikely. For example, my friend’s grandfather used to carry Snickers Bars with him all the time, on the advice of his doctor. Of course, that’s because he was diabetic, and there were times when he’d get low on sugar, so it was completely appropriate.

(I know nowadays diabetics will carry a tube of glucose for such purposes)

FedUpWithIgnorantPeople

Actually, I agree with you.

My comment was snarky, since the author “left medicine”, I don’t particularly believe she is any further qualified to tell me what I should/should not believe than my licensed/certified midwife (a highly trained OB/GYN as well). My background is in psychology and statistical analysis. I am capable of reading and interpreting raw data and stats. I am far more qualified to do that than I assume the author in question is–as she did not study it extensively as I did. I am far more capable of making my own decisions based on evidence and stats than most. So, if I choose not to listen to “quacks” OR former OB/GYNs, that is my choice.

Basically, if you aren’t still in the field, no longer teaching, and are not up to date on research, what qualifies one to write about how OTHER people aren’t up to date on research or how they don’t know what they’re talking about?

She’s telling us to listen to and read from “qualified” individuals, but she herself is not licensed and currently practicing (at least I hope not–practicing without a license is a felony). In my book, that places her squarely in the “unqualified” category. So, to tell me that I can’t make my own decisions as a lay person when she, herself, is a lay person is rather presumptuous and egotistical.

Stacy48918

“Basically, if you aren’t still in the field, no longer teaching, and are not up to date on research”

Um….wrong, wrong and wrong.

Dr. Amy recently lectured for ACOG. That pretty much puts her in the field, teaching and up to date on research. If anything, she’s likely MORE up to date on research than many OBs “in the trenches” since she’s not also seeing patients.

“So, to tell me that I can’t make my own decisions as a lay person when she, herself, is a lay person is rather presumptuous and egotistical.”
Deciding not to renew your license because you aren’t going to be practicing any more does not automatically wipe one’s mind of all the medical training and make one a lay person overnight. Ignoring of course the ACOG lecturing. To think that you as a “lay” person are magically on an educational and informational par with a non-practicing doctor of ANY stripe is EXTREMELY presumptuous and egotistical.

Stacy48918

In other words, you don’t actually have any substantive, factual arguments – you’re simply deferring to an ad hominem as your reason for disagreeing with anything Dr. Amy says.

Gene

A midwife is NOT an OB/Gyn. Any more than a psychologist is a psychiatrist. But I’m sure you know that.

There are quite a few fully licensed and actively practicing physicians that participate on this site. Myself included. I do not have the time to maintain a website such as this, but my medical training and practice gives me the ability to critically interpret Dr Tuteur’s posts and I find them scientifically valid.

So if you won’t take her past training into account, take my CURRENT training (and the others here).

The Bofa, Being of the Sofa

Besides, what exactly is Dr Amy saying that is not the mainstream position of the ACOG? There are bits and pieces where she disagrees, but overwhelmingly, what she says is the mainstream position of working OB/Gyns.

Captain Obvious

So, along the lines of your criteria, she is not actively practicing, but she is still up to date and teaching. She was even asked by ACOG to be a presenter at the 8/2013 division meeting in Maui. She is well educated in statistics. And since I have been following her blog for the past 2-3 years, she posts reviews about articles as they get published, sometimes before they get published. Many licensed doctors don’t read current articles until they are looking up a particular topic they need to review.
As it is, the MANA survey and the Cornell study along with research of other countries nurse educated midwifes, as well as our own State’s data about American Homebirth safety, I believe Dr Amy is quite uptodate and educated. Just because you are not currently licensed doesn’t make you an idiot. Would you allow your retired cosmetologist aunt cut your hair? Or retired architect friend help design your house? Or are they all just idiots now too?

LibrarianSarah

So according to you the second you retire the decades of knowledge and experience that a person had throughout their careers shoots out out of your brain. I am sorry but I call bullshit. Amy does keep up on the research and is asked to speak at professional conferences. Would you like people to stop taking you seriously once you retire?

carbsane

+ One Zillion for #6 Baffling with Bullshit is one of my favorite sayings of all time!

I am a totally pro-vax person, spending endless time … not with antivaxers but with those who really have doubts, are not so sure, are worried, are open to information and articles such as the ones on this blog.
On the other hand, I am uncomfortable about dismissing “conspiracy theories” since 2010. I am not saying “big pharma wants to hurt us on purpose” – I just came to think that they want to make money, and it might be wise to think twice about what they actually sell to us, do we really and truly need it, are we absolutely sure indeed that buying is our best option in the given situation. I just say “Poland” to support my point, and if anyone has more information, that would be welcome.

Young CC Prof

This document implies that the Parliament questions the actions of health authorities because they think H1N1 was a non-event. That’s both unfair to the health authorities and not entirely true.

Yes, H1N1 ultimately proved to be far less deadly than the last great plague of 1918. But when it first came to the attention of the authorities, no one knew that. It was known that we had a novel influenza virus, striking out place and out of season, and that school-aged children and working-aged adults were desperately ill or dead. A dangerous novel influenza is every epidemiologist’s worst nightmare, and, in the absence of complete data, they HAD to act on the assumption that the Big One had arrived.

No, it was not a non-event. H1N1 is not a normal flu virus. In the USA, it killed a confirmed 350 children, some of them previously healthy school-aged kids, and an estimated 10,000 adults, most of under 65. (Many elderly Americans had partial immunity.) Regular flu viruses do not do that. Further, without modern critical-care technology, the death toll would have been far worse. In November of 2009, the US hospital system was stretched to the limits by patients with severe respiratory infections.

Not more information, but we do need to keep aware of pharmaceutical profits. It is surely no coincidence that not much research is going on about antibiotics – seeing that they are needed for only short courses. Meanwhile anti cholesterol pills are all the rage – seeing that people take them for decades, (yet there’s no evidence that cholesterol in itself actually causes illness.)
I am totally pro vaccination, especially for the childhood risk – polio, whooping cough, diptheria,etc, but I am a bit dubious about the regular yearly flu vax . It’s always worth questioning – “What’s in it for whom?”

The Bofa, Being of the Sofa

The flu is a major killer around the world every year. Why do you need a conspiracy to account for why anyone would want to prevent it?

I don’t see any conspiracy. It’s just the commercial imperative. (If they found a cure for Alzheimers they’d be right onto it- commercially good, but at the same time, a public good)
Flu vax probably does save some people. I just suspect that it’s unnecessary for many. And – every drug carries some risks – however slight – so people should consider whether they really need that flu vax – especially for kids.

Young CC Prof

Let’s put it this way. Assuming you’re a healthy nonpregnant adult under 60, the probability that you’ll die from the flu is very small. But the probability that you will be hospitalized, develop bacterial pneumonia, or otherwise be ill for more than two weeks is much higher than the probability of a severe reaction to the flu shot, high enough to be worth considering. And any severe respiratory infection can cause long-lasting lung problems.

If you are under age 5, over 60, immunocompromised, pregnant, or live with someone who is, it’s very important that you get vaccinated. If you have regular contact with an infant under 6 months, it’s critical, since new babies can’t be vaccinated and have no other defense, other than the fragmented and fading maternal antibody collection.

Young CC Prof

The antibiotic problem is definitely an issue with the pharmaceutical funding system and profit motive. Statins are now generic, though, so not as much of a money maker any more.

Flu vax does make a difference, though, and it’s NOT a big money-maker for the drug company. Making sterile injectable medicines is hard, and at $15-$20 per dose, they’re hardly showing a profit at all.

pixel fairy

i always avoided the flu vaccine to help avoid shortages for children and the elderly. always thought anyone healthy, and with a strong immune system, should.

now id like to see statistics of people who do and dont get the vaccine and do and dont get the flu.

could those of use avoiding the vaccine be spreading the flu without getting it ourselves?

Young CC Prof

There hasn’t been a shortage in a while, since the government stepped in. If there is a shortage, definitely get let the needier people go first, but most years the supply is ample. Why not get it just to be safe? Being sick stinks, after all.

It’s tough to measure the exact effectiveness precisely because people who are already vulnerable are much more likely to get the vaccine. However, in the past couple years, 90% of flu deaths were in unvaccinated children, while less than half of children were vaccinated. And, the vaccinated group included most of the high-risk children.

Now, if you don’t get sick, you’re not spreading the flu.

Kwehrheim

I actually enjoy being sick. I sleep really well, and it gives me an excuse to sit at home and do nothing. It’s the only time I can be lazy guilt-free. Unfortunately, my warm embrace of disease has given me a military-grade immune system.

Trixie

Uh, there haven’t been shortages in years. The CDC says everyone over 6 months should get a flu vax unless there’s a specific medical reason not to.

The Bofa, Being of the Sofa

The last shortage was H1N1, and, in that case, the CDC made their recommendations in line with the fact there was a shortage, until the supply caught up.

IOW, just follow the CDC recommendations. Let them decide whether we need to ration.

Your theory re spreading the flu is reasonable. However, I can’t see that the flu is in the same category as polio, whooping cough, TB smallpox etc.
The knowledge about flu is complex, as new viruses pop up all the time. Flu does kill some people, but often with bacterial infection on top of it.
Most people recover unscathed (and perhaps with some immunity)
I passionately support child vaccinations for the traditional horror diseases. But I’m less sure about the flu vax.

True indeed. But it’s not always quackery. History shows us that many measures were taken in good faith, but turned out to be mistaken. Medicine has historically (and still?) been trial and error.

AD

Wow, guess I am a quack. Not interested in ‘quack-proofing’ myself based on the points made in this article. Several are simply lies. Just are.

Dr Kitty

Cite?
Which are the lies?
What is your proof?

Parachuting quack troll, you need to provide some evidence to back up your assertions.

Anything else just looks like an ignorant fool content to remain ignorant.

Renee

Cool see ya later then!

Sue

Why would someone go to the trouble of commenting with a whine and essentially no useful content in their comment?

Who?

I think AD might have 1 and 2 with a dash of 5.

Kwehrheim

I’m thinking there’s some 4 in there too.

Something From Nothing

Please put down your deepak chopra book and elaborate.

Kwehrheim

Based on the points made in this comment, yeah, you’re a quack. Waddle away now.

Deena Chamlee

http://www.scientologyhandbook.org/suppression/sh11_2.htm
This blog write is an interesting read. And I cant believe it is associated with scientolgy. Of course I know nothing on the practice of scientology. But if you want to get perked up of the day I suggest take a couple of minutes to read it.

Trixie

L Ron Hubbard was a bad, bad, very bad man.

Deena Chamlee

Lol well like I said I know nothing about scientology. So may it does relate even more to this post. The flattery flag.

http://www.antigonos.blogspot.com/ Antigonos CNM

My father, who was a hard-core SF fan from the 1930s, told me that L. Ron Hubbard [who wrote some good SF, according to Dad] openly decided in the 1950s that all religion was bunk, and to show that it was true, announced that he could create a religion that people would take as seriously as the established ones, and Scientology was the result. Hubbard was entirely cynical about it, he said. I don’t know if that is true; I’ve heard much the same from others, as well.

Certainly some of the “exposes” that have come out about the cult are extremely disturbing.

The Bofa, Being of the Sofa

I don’t know about his motivations, but Hubbard absolutely did say that anyone could create a religion, completely made up, if they wanted to.

That he turned around and did exactly that always seemed like it should be a major red flag, but there are those who don’t care, apparently.

Then again, add in the tenets of scientology, and the whole Xenu the alien crap, and you just have to wonder.

Renee

You have to understand, the stuff about Xenu and all that was secret! Until the last 5 years, it was only available to a choice few members, so it was not unreasonable at all to believe in what the new members were taught. Add in the cult tactics of love bombing and making the person feel like they are special, and its potent. And its not alone in this, other belief systems use it too. N

IMO, even all the Xenu stuff isn’t much more ridiculous than other religions. They all look silly if you take all the trappings and traditions away and strip them down (I won’t insult people by describing how this is.). WE see Xenu and the alien souls, but it was enmeshed in a much bigger story.

Dr Kitty

Narcanon is a Scientology rehab.
High doses of vitamins, saunas and staring at people replace actual therapy and doctor supervised detox.

The name being almost like Alanon isn’t a co-incidence.

It is one thing when competent adults choose to get involved in Scientology, another when desperate families send their addict relatives to a Scientology rehab out of desperation and ignorance. Pretty much the definition of exploitation.

Don’t they give huge doses of niacin to induce sweating?
They also have some weird beliefs about childbirth. Not only must the mother forgo pain relief, she must be completely silent, too.
Also the part where they make 7 year olds sign contracts for a billion years and then put them to work as slave labor in the Sea Org.

The Bofa, Being of the Sofa

Large doses of niacin will certainly cause sweating. Don’t know what it would be good for, though.

Guesteleh

I find a lot of the hyperventilating over Scientology to be hypocritical considering that the Catholic Church has spent decades protecting known pedophiles, to the point of bishops and cardinals perjuring themselves and hiding church assets to protect them from lawsuits. Scientology may be evil but there is plenty of nastiness in mainstream religions as well.

Renee

Exactly.

Irène Delse

Didn’t he at first try to establish Dianetics as a new science/health regimen, too, and got slapped with lawsuits for illegally practicing medicine, or not paying taxes? Then emphasized the religious aspects of his invention? It also tidily enabled his organization to enjoy the tax exemption status of a religion.

Trixie

Yeah, tax evasion and wealth consolidation were the main motivators. He was also awful, just horrible, to his wives and children.

Trixie

Going Clear by Lawrence Wright was an excellent read. Hubbard was a hypocrite and a liar for sure, and he clearly made the whole thing up, but he also started to believe a good bit of it himself by the end.

Craig Good

This is an absolutely wonderful post. I’m sharing it on every channel I can think of. Thanks for writing it.

Deena Chamlee

A Paradigm Shift Requires Open Minds Dr. Amy. There are many ways to safely bring the shift into a new paradigm.

But many scientists, although they might quibble about the details, know that Kuhn, a physicist-turned-philosopher, was on to something.

For the most part, Kuhn said, scientists practice “normal science.” They work within a particular theoretical framework, or paradigm, in which the big picture is taken for granted and new experiments fill in details. All results are interpreted in terms of the paradigm (or as Kuhn later called it, the “disciplinary matrix”).

Sometimes, though, crises occur. An anomaly — a surprising result — stubbornly resists all efforts to force it to fit into the paradigm. Eventually the anomaly is removed only when a new theory, incompatible with the old paradigm, succeeds in explaining it. Then a new paradigm replaces the old one.

“When the profession can no longer evade anomalies that subvert the existing tradition of scientific practice — then begin the extraordinary investigations that lead the profession at last to a new set of commitments, a new basis for the practice of science,” Kuhn wrote.

Such a shift is what Kuhn called a scientific revolution. In his famous 1962 book The Structure of Scientific Revolutions, he mentioned that novel paradigms usually arise from scientists new to the field. “Almost always the men who achieve these fundamental inventions of a new paradigm have been either very young or very new to the field whose paradigm they change,” Kuhn pointed out.

I have no idea where you get that the young are discouraged from thinking outside of that box. Not my experience at all.

Deena Chamlee

It wasn’t me, it was the author in the article regarding research on scientific revolutions. And I am glad whatever your profession that you are encouraged to think outside the box, not always an easy thing for any of us regardless of our age in my opinion.

Siri

I am having a home birth. I feel like I have done my “research” on the topic, and I have looked at both sides. When I first began looking into home birth, I only read what I wanted to hear; the natural birthing side. When I came across this blog, I was shocked! I had NO idea that the midwives at my local birthing center had never gone to school for more than a year. In fact it was family run, so many were midwives right out of high school. So although I am still having a home birth, I have to thank you doctor Amy for giving me the correct information and facts to find the safest path for me. I found myself a nurse practitioner/nurse midwife/ naturopathic doctor to be doctor through the process. I have had two normal pregnancies and births, and feel confident in giving birth at home. Am I still taking a risk? Yes, but it is very, very small. But I am interested in what the risks are for someone who is having a home birth after two normal pregnancies and births? When you wrote about the real risk of having a c-section it seemed to be first-time moms, previous c-sections, and risk factors. It seems that most babies born at home that die are usually from a pervious c-section, meconium, long labor, and water broken for over a day. Most of the deaths seem preventable just by using common sense. Is home birth really that risky if it is done right? Is using someone who KNOWS the risks and has seen them in a hospital setting substantially safer? I ask these questions because I cannot find information in this area. I seem to fit in a group that doesn’t exist; I want a home birth with a doctor or nurse midwife.

Siri

I know that people will attack me for wanting a home birth, but I would love if someone can tell me honest risks for myself. Age 28, healthy, 3rd birth, 2 hospital births, quick 8 hour labor, 10 minutes of pushing, small 6 lb babies, no tearing, no illnesses, and family history is equally the same as mine. I can only think that the risk is probably below .01 percent. Yep, that’s still a risk, but there is also a risk I will die driving my car, and I still drive.

Young CC Prof

According to MANA’s own data, it’s not 0.01%. Women who have previously had normal vaginal births had a 0.124% chance of losing the baby at home birth, compared to around 0.04% risk of intrapartum or neonatal death at the hospital. This is similar to the risk of your child dying in an accident at any point up to the age of 18.

Also according to MANA’s own data, the risk of postpartum hemorrhage at home birth was 15%. These women survived, but some needed emergency transfer and many had a very hard recovery.

Definitely get all your prenatal testing. Risk factors like preeclampsia or gestational diabetes can pop up even in women with previously healthy pregnancies, and the probability of having twins or a breech birth actually goes up in subsequent pregnancies.

Make sure you have a hospital to transfer to and a plan to get there quickly even if you can’t walk. Make sure you have a pediatrician who will examine your baby promptly within 24 hours of birth even if everything looks fine.

It’s your choice. I just want you to have all the facts. May I ask what attracts you about home birth?

Trixie

And that’s just the risk of death. The risk of permanent brain injury is, of course, much higher.

Deena Chamlee

Do you really trust anything that paper said? OMG with all our knowledge. Most of the midwives put the data into MANASTATS retrospectively or more importantly refused, oppositional deviant. The numbers are worthless just like anything coming out of that organization along with NACPM.

Trixie

Deena, her point is, even with MANA trying hard to make their numbers not look terrible… They’re still terrible. So this is the best-case scenario,but the real numbers are probably worse.

Deena Chamlee

Of course they are worst. There is no telling how many babies we have lost. How many who never received a death certificate and are buried in the grieving parents backyard. Trust me I lived it in Portland and what I experienced in that city will forever haunt me.

Irène Delse

Oh, how awful. Talk about the dark side of the ‘back to nature’ dream…

KarenJJ

Wow. It had crossed my mind that it might be easy for a lay midwife to literally bury her mistakes like that but I’ve never said it on here in case it was just too dark a thought. Especially with the “off the grid” culture in the US.

Young CC Prof

In the MANA STATS data, there were 4 babies who vanished out of the data set. The mother transported to the hospital during labor, and the midwife claimed she didn’t know how it turned out.

Semi-legal home birth midwives do bury their mistakes, both literally and figuratively. Look up “not buried twice,” on Facebook and elsewhere. It’s a reference to home birth’s cultural tendency to deny that mistakes ever happened.

Renee

That is horrible. And not surprising.

fiftyfifty1

So if we are to believe the MANA numbers (which I don’t because they are likely underestimates) but anyway if we are to believe them, for every 1,190 low risk women (multip with no previous c-sections and carrying a single vertex baby) who choose homebirth, one baby will die who will not die in the hospital? Am I doing the math right?

Deena Chamlee

Siri I would never attack you. Make sure she has a back-up provider OB/GYN, you are no more than 10 minutes from your local hospital, the hospital labor and delivery are aware of your plan and has a copy of your prenatal records beginning at 28 weeks just in case issues arise and lastly, make sure when you go into labor yourself, your husband or your provider notifies labor and delivery along with your progress during intrapartum. I would also make sure she went to a graduate prepared nurse midwifery program. Some naturopathic doctors are calling themselves midwife but are not a midwife they are a naturopathic doctor. And if this is the case as Amy says run the other way.

Trixie

Make sure you actually speak with the so-called backup OB to make sure this is actually the case and the midwife isn’t lying about it.
If I were considering a home birth, I’d only do it with a CNM who had a written practice agreement with/supervision by an OB, and who also had hospital privileges. That doesn’t weed out all the dangerous practices, but it does reduce the likelihood that you’re getting a quack by a bit.
And be aware that “10 minutes from the hospital” isn’t close enough to prevent brain damage.

The Bofa, Being of the Sofa

Moreover, the MW should have such a good relationship with the hospital that you would be pre-checked in to the hospital, such that if something were to happen and you needed to transfer, you wouldn’t have to waste time checking in.

Can your midwife arrange that? If no, then her agreement with the hospital is not sufficient.

Trixie

Agreed.

Deena Chamlee

Siri, I had to step back from this post for a few minutes because of my involvement as a midwifery provider, a damn good one I was and I don’t mind stating that fact, because I have left the profession due to ethical beliefs among other things I can not discuss.
This is what I feel impelled to share.
Those who practice midwifery in an out of hospital setting, CPM/CNM have refused to incorporate national safety standards for mothers and babies. Therefore, I am going to strongly encourage you to find a hospital that offers suites that are very nicely furnished such as in the home. All the data on homebirth shows an substantial increase in babies either suffering damage. such as brain issues (neonatal hypoxia ischemia from lack of oxygen) or death. Given the fact that all midwives are affected by midwifery’s leadership regarding out of hospital birth, it unfortunately leads me to recommend against such endeavors.
My recommendation would be go to the hospital and ask them for an early discharge within 12 hours if possible. Then schedule the PKU in the pediatrician’s office the following week. And call your insurance company to see if a home health nurse can follow-up with you at 24 and 48 hrs post delivery.

Trixie

I delivered at a hospital that offered a home health nurse who was also an IBCLC at 2 days after discharge. It was wonderful! She was not woo-y at all, weighed the baby, evaluated her touch of jaundice, was prepared to give feeding advice no matter how the baby was fed, and screened me, too.

Siri 2

That is some very good advice. I will honestly look into it. I would love to get discharged early.

Ash

I do not know where you live in Sea-Tac but their are a variety of birthing centers in hospitals that offer services like private birthing suites including bathrooms, space for family members to stay, birthing balls, squat bars, and other amenities. I

Amy Tuteur, MD

We already have a Siri as a regular commentor. Could you call yourself Siri2?

Deena Chamlee

Maybe Siri is not the Siri but wanted to see a reaction from the empaths.

fiftyfifty1

Were your babies full term and truly 6lbs and not more? Because if that is the case, they are in the range of being SGA (small for gestational age, i.e. less than the 10th percentile for weight based on gestational age). SGA babies are at higher risk of peripartum mortality. Make sure to ask your CNM to calculate the percentile for each of your previous 2.

UsernameError

My longest gestation was 38 weeks, and she was 6 and a half pounds. She wasn’t considered SGA.

So at 38 weeks, normal would be 6.5 lbs. Your baby was normal size for being 38 weeks.

(someone has actually posted the normal growth chart. It shows that my Rule of Thumb that I had created just based on my impressions is, in fact, pretty much right on the mark, to scary level, in fact.

Siri 2

I guess I will call myself Siri 2. Sorry, I didn’t know there was another Siri :/ thanks for your honest answers. I live in the seattle area, and the clinic I found has only cnm and nurse practitioners and naturopathic doctors. They run their own birthing clinic, but I would rather have a baby at home than in a birth center; they literally seem the same to me. I will have to research more and ask lots of questions. I haven’t even scheduled an appointment yet, so I could change my mind. I’m not in denial about the risks, but I do feel safer with someone who has professional experience vs a certified midwife.

Trixie

Okay. A naturopathic “doctor” is not the same as an MD or a DO. Like, not even remotely. An ND does not have real medical training and having a home birth with one does not make you any safer than having a taxi driver deliver your baby. NDs, for example, can’t practice in any hospital. By definition, they are quacks.

You need to ask about what type of liability insurance they carry.

Bombshellrisa

the ND doctors in Seattle deliver babies under a LM or CPM license. Just Google Seattle ND and midwife and you will Elias Kass (the one who “fixes” tongue tie) or Brandy Ross, who was disciplined multiple times and who still catches babies because she is now an ND. What is worse is that there are midwives who haven’t been disciplined and who had had losses, like Beth Coyote because the families buy into the midwife claiming that everything was “fine” and all of a sudden at the end the baby just “didn’t make it”.

Trixie

That guy is the worst. Advertising himself on the internet as able to fix “posterior tongue tie,” a condition that doesn’t even exist. Performing surgery on babies’ mouths despite having no training or qualifications to do so. Writing articles for Lamaze as if he is qualified to speak about science. Ugh.

Young CC Prof

Fix posterior tongue tie… Aren’t tongues supposed to be attached in the back? To, like, keep it from falling out of your mouth?

Laural

Ugh. Reading what you and Trixie wrote makes me feel queasy. My baby couldn’t nurse and the LC said posterior tongue tie- agonizing decision to travel to the states from Korea and see a pediatric dentist and he treated my baby and 1 year old, who also had severe lip and tongue ties. I was so afraid of the woo but after long consults with my pediatrician etc. we did it. Dr. Kotlow in NY. We went from exclusively pumping to exclusively nursing after a 10 minute procedure and my 1 year old’s teeth have already moved to close the gap from his lip tie and his tongue is good as well. I guess even after all that I am still insecure about it. Posterior tongue tie is definitely mired in woo. I saw an ENT who said posterior tongue ties did not exist and that the problem was probably neurological. We agonized over what to do. G is #5 and I nursed them all- she could not suck and swallow correctly at all. She could not even get milk from a wide based bottle nipple, like Nuk. She was getting nothing from me despite desperately trying and I had to pump and feed her with a long skinny nipple, like Dr. Browns, or the kind they have in the hospital. In the end our results were life changing. I wish the tongue tie revision had been just a simple thing that my doctor did when we realized she was not getting any milk and not some awful journey of pumping and going to LC’s and ENT’s and having to go into woo-land.

Trixie

I’m so sorry, but I’m glad you got it straightened out eventually!

Laural

Thank you, Trixie. Me too!

Bombshellrisa

He has an engineering background, so he is obviously thinking he can apply that to midwifery and medicine. He is also the only male licensed CPM in the state, the other one had to surrender his license.

University of Washington-lol-they probably were looking at all the patients who got treated at Bastyr’s clinic or by their ND graduates

An Actual Attorney

Siri2 — Google Evelyn Muhlhan, a midwife in MD whose license was suspended. A CNM isn’t a guarantee of safety. And ask the midwives you are thinking of what they think of her and other midwives who have been investigated? Do they rush to their defense, no matter what, or do they call out people who take unnecessary risk?

Jessica S.

Evergreen Hospital in Kirkland has an in-house midwifery program. I wonder if it would be possible to even just talk to one of the midwives on the phone, tell them what you’re thinking and see what they have to say? From what I understand, the midwives there do it all – there are OBs in the hospital in case there is an emergency, but if not, you won’t see them. I don’t know if they could just take general inquiries over the phone, I’m sure they couldn’t consult on your specific situation but they might be able to provide insight.

All that said, Kirkland may not be near your area. Good luck!

Bombshellrisa

Valley Medical Center in Renton has The Midwives at Valley, a six CNM practice who deliver at the hospital and do great care. Swedish Medical Center is a great place to deliver, 9,000 babies born there a year and a lot of the Seattle CNMs have privileges there. Swedish Ballard is the best place for a CNM birth if you are close by there, they are well known for their midwives and being a very cozy (yet still safe!) place to give birth. I recently gave birth at Swedish medical center Issaquah and it’s the closest place to feeling like home while still having everything available if anything should happen.

Boundfate

I guess my question to you would be:

“what are the rewards of homebirthing?” What are you looking to get out of this, your third birth, that you were missing at the hospital? Because in the Seattle area you have a wealth of hospital choices, most of which will bend over backwards to give you the experience you want, all while having an OR prepped for that 1 in 10,000 chance that you need it.

I have a 1 year old. I look at him and to really feel and quantify risk I think about placing him in a group of x people on a local college campus (whatever the risk # is) and then turning a gunman loose knowing the gunman will kill one person. What would it take for me to drive him there to be 1 in 1,000, 1 in 10,000? There are some things (we started co-sleeping at 6 months, 1 in 30,000+ risk from what I could tell), but I’ve found when I picture what I want vs. what I could lose, most of the time I am risk adverse when it comes to him.

RN who has seen too much

Hi Siri 2,
I am a labor and delivery nurse. I can think of many cases where we have saved babies and moms that would have died at home. One thing that you are more at risk for with a 3rd baby is post partum bleeding. Especially with your history of relatively quick labors. Even with pitocin, which is routinely used in hospitals to prevent this, some moms will still experience life threatening bleeding. Even with an MD at your house, he or she may not be able to stop this bleeding with at home remedies, or even pitocin if they are allowed to carry it. Post partum bleeding is the most common cause of death during childbirth and sometimes you need a procedure in the OR to stop it. For most women with a life threatening bleed, the time it takes for you to get an ambulance to your house and transported would be too long. A lot of people think, well I will have my midwife or husband drive me. I would like you to think about that for a moment. When you lose a lot of blood, you begin to be lightheaded and some women pass out, they will likely need to carry you to the car. The midwife will need to be massaging your uterus during the drive to try and keep it firm. Your car will be essentially ruined with the amount of blood you will be losing, but that will be the least of your worries. You will most likely be unconcious when you reach the hospital, and it will take even more time to get you transferred to the unit where they can help you, and into the OR. It’s a huge risk. I would like to know why you prefer a home birth? What is it about the hospital that you don’t like? The other good thing about a hospital is that you usually have an NICU there in case there are issues with baby. Sometimes babies who are born quickly come out stunned and need a little help to start breathing. It is helpful to have more than 2 sets of hands to help do all the things that can help baby get a good start. For example, one set of hands to stimulate baby by rubbing his back and feet, one set of hands to give baby a little extra oxygen or start CPAP which helps give baby even more help, plus, you need a set of hands for YOU, if you are bleeding profusely, and baby also needs help, what is going to happen then? There are many people who deliver at the hospital that could have easily had a safe delivery at home. there are many others who thought their birth (yes, even a 2nd, 3rd or 4th delivery) would go totally normal, and they are thankful for the advent of medical technology that saved their lives. By choosing homebirth, you are taking an unneccessary gamble with both of your lives. Could everything go perfect? Of course it could, but if something goes wrong in homebirth, there is no going back. Why wouldn’t you want to do all you could to assure that you have a healthy outcome for you and your baby? You don’t have to use the hospital technology if you don’t need it, but if you DO need it, you have the peace of mind of knowing it is right down the hall. At home you have no peace of mind, only a hope and a prayer that you won’t need to use it.

RN who has seen too much

Oh, one more thing in response to your driving a car analogy. Do you wear your seatbelt when you drive? Make sure that your brakes work and maintenance is done so that nothing goes wrong while you’re driving? Do you prefer a car with airbags vs one without? Do you put your children in carseats? These are all examples of how you use modern technology to reduce risks of driving a car. Having a homebirth is like knowing that the chances of you getting in a car wreck are slim, so why bother with a safety belt/car seats/airbags etc. You see my point here? A hospital is your safety belt, your airbag in case of crash. When people talk about the “risks of interventions” of hospital birth, I can’t help but consider the risks of the airbag (it could break your nose when it inflates) or the seatbelt (you might get whiplash or a bruise)…..even with all the “risks” of these safety devices, we still use them because they reduce the risk of death from the accident. It is the same with the interventions at the hospital.

But the risks of not having an airbag and not wearing a seat belt are so much higher than wearing them, even if you are a short, skinny person, that we still say everyone should use them.

Renee

I don’t think any one will attack, and I appreciate that you are asking.

Jessica S.

No attacks!

I replied to your original comment (see above) and it still stands: there are some things you can’t predict happening, and while the risk is low, it’s a huge loss if you pull the short straw.

Trixie

Is disqus playing tricks on me? Is this really Siri?

The Bofa, Being of the Sofa

I seem to fit in a group that doesn’t exist; I want a home birth with a doctor or nurse midwife.

The vast majority of doctors or nurse midwives won’t do homebirths, right? Why do you think that is? Perhaps because they believe that it is too risky?

Now, you will find an occasional CNM or (even less likely) doctor that will do an OOH birth. Then again, pretty much by definition, they are in the extreme in their beliefs about the suitability of homebirth. It clearly is not the mainstream position.

What do you think that means in terms of their capabilities? Given that they are in the extreme, you can’t assume that they hold mainstream capabilities. If, as you say, they recognize the risks of homebirth but do it anyway, maybe it just shows them to be reckless?

So now go back to the question. Do you really want to have a birth with a reckless provider?

Trixie

In my area, there’s a CNM group with a practice agreement with an OB group. They have an accredited birth center, do home births, and also attend hospital births. Mostly they do home births because of the large Amish and Mennonite population that will home birth no matter what, and they’re trying to at least make it a safer experience than the underground CPMs are providing. So it does exist, but only because of very unique market conditions here.

Starling

I was thinking about a home or birth center birth with CPMs. What changed my mind was reading a blog post by Young House Love. They have absolutely no stake in the home/hospital birth discussion–they’re interior design bloggers. But their birth story shows how even a perfectly healthy person with a perfect pregnancy can have a catastrophic emergency during labor, one that would have resulted in death if they had chosen homebirth.

Their little girl is four now, but she would have been stillborn had they not been able to give Sherry a c-section within four minutes of diagnosing a placental abruption. And even then, it was touch and go–the cord prolapsed as they pushed her into surgery. (http://www.younghouselove.com/2011/04/claras-birth-story/)

These things really happen. Babies really do die. Children really do grow up with severe injuries. The likelihood that your baby will be one of them is small–but you have kids. What’s your risk tolerance for them? Do you drive to the store without buckling them into their car seats? Do you just forgo car seats and seat belts altogether? Because either of those is less likely to end in your child’s death than having a homebirth is.

I just wonder what about skipping the hospital is worth that increased risk. Is it possible to find a birthing-within-a-hospital in your area, or otherwise improve your experience without compromising safety to this extent?

UsernameError

Siri, with my third pregnancy I developed ICP. No family history, either. With my second pregnancy we discovered I had developed antibodies. My husband and I are both A+ blood types, but there are other antibodies you can become sensitized to with absolutely no forewarning. If it hadn’t been for a routine blood test during delivery, we would have never known. There was no pregnancy trauma and no bleeding during pregnancy. Just because you had a normal pregnancy, doesn’t mean it will continue. And just having those little routine things done at delivery, like checking antibodies, has potentially saved the lives of the other children I had. Does your midwife check for those? Does she even know what other antibodies a woman can be sensitive to, or does she think that as long as the mother is not rh negative there is nothing to worry about?

What are you going to do about the vaccinations? Vit K? Newborn screens? Eye ointment? Cord blood gases? Does your midwife know the normal respiration rate of a newborn, the normal blood pressure, the normal heartrate? What about checking for jaundice? Does she know the signs of respiratory distress in newborns, which are so subtle they can be quite insidious. Is she certified in neonatal rescus? Does she have her STABLE cert? PALS? There is a lot more to birthing babies than just catching, encapsulating a placenta and going home.

theadequatemother

Why are you on the Internet asking a groups of strangers what risks you would be taking to have a homebirth? Aren’t those risks supposed to be discussed between you and your midwife/wives as part of informed consent? If you don’t trust that they will have an honest discussion with you, incorporating what we know about risk from the studies that have come out in the last few years, why would you even consider birthing with them?

Bombshellrisa

Siri2-if your naturopathic doctor does home births they do it under the CPM license.http://www.midwiveswashington.com this is a good resource to do research on midwives. If the midwife is indeed a CNM you can still check credentials on the Washington health licensing website.

lawyer jane

Hi Siri,
I am not a medical professional, but at one point I considered homebirth. I come from a “crunchy” background and one of my siblings was born at home with no problems. But once I thought about it, I quickly changed my mind to a hospital birth with midwives. Here are two main reasons I changed my mind:

1) Risk and responsibility. Birth is “normal,” but statistically is it one of the most dangerous days of a baby’s life. When I learned more about everything that has to go well for a safe birth, I realized it was an enormously complex physical event for mother and baby. Most likely we would be ok at home, but I could never forgive myself if something went wrong that could have been solved at the hospital. As it turned out my baby did have to go to the NICU for a few hours. Even though I would have been more comfortable and rested at home, ultimately I was not able to justify putting my comfort above the baby’s health (and my own health!).

2) Consistency. I realized that in all other areas for both myself and my baby, I worked hard to make sure I was ensuring that we would be safe and take advantage of the best available medical care and technology. I picked out a carseat, made sure it was installed correctly, got prenatal care and tests. I read up on safe sleeping and SIDS prevention to make sure we got a safe crib and put the baby to sleep on his back. Once my baby was born, I certainly never hesitated to call the doctor or go the ER in one case when he was very sick! So … when I thought about it, I realized it made absolutely no sense at all that I would use the best available medicine and technology to keep myself and my baby healthy on every day of our lives except the MOST dangerous one – the day he was born! So to the hospital we went.

http://www.antigonos.blogspot.com/ Antigonos CNM

Are you going to live-blog labor and birth? At the least, you should write up your experiences after your baby is born, and especially if the birth “lived up” to your expectations.

Renee

Siri-

I respect your choice, and admire that you have been open to reading all of the risks and downsides, especially on this site. While I would never choose HB (no pain meds, no thanks!), I can see how it would be seen as desirable to others. Weighing risks, with appropriate info, is what its all about. I have no prob with HB when mom is actually informed (I still have problems with deadly MWs and all that, but that is another topic). I hope it goes well, everyone is healthy and happy, and is an excellent experience for you.

I am going to tell you my opinion, because you asked.

First- I can think of one such MW that fits that description (Naturopath, CNM, NP) and she is a MENACE, though she is beloved by some very vocal followers. I sure hope it’s not the one I am thinking of. Mind I ask what region you live in? (Areawoman, do you know who I am thinking of?)

In MY opinion…

Most good CNMs don’t do HB- the more they see, the more they know, the less they think HB is acceptable. Few OBs do it for the same reason. Its ideology/scandal that makes these type of HCPs go out and do HB, which is NOT a good thing.

TBH, CNMs, MDs that do home birth are generally a danger to their patients. These are often disgraced, exploitive MDs that lost their privileges, and use NCb as a way to gain followers, like Biter and Fischbein. As well as CNMs that don’t play well with others (Cara Mulhahan from BOBB), because they are too zealous/radical, or just unprofessional and disorganized. Choosing to practice with lay MWs also shows an enormous lack of judgement, and is a red flag.

There are SO MANY examples of CNMs that are deadly, that took YEARS to do anything about- and are still beloved by others. The MDs are just as bad. HB CNMs seem to be even MORE wedded to their ideology than even some of the CPM/LDEMs. They have traded their education for their beliefs, yet still feel they have superior knowledge, leading to over confidence in their abilities and judgement- not good.

The isolation that they have in their solo or small/BC practices with other NCB ideologues, is also very detrimental. Even if they start out skilled, being in an echo chamber with zero accountability and no criticism is very damaging to ones skills, as is doing only a few births a month. At home, no one is there to correct them, or catch their mistakes. OOH HCP have no limits on what level they allow their ideology to influence their actions.

Technically, HB CNMs have a 2x higher death rate OOH, and CPMs re at 3x and up, based on white women with education, at term. The OOH CNMs with the best stats are ones in accredited BCs, like the one owned by our local hospital- this is NOT HB. Naturopaths are too few for good stats, but the one I know here did kill a baby.

I cannot tell you how much these numbers would improve if the obvious high risk cases were removed. It’s hard to tell. But to be fair, who knows if you are high risk if no one tells you, because they don’t define it the same way you do? Many of these moms thought they were low risk too.

Also- IMO only, an NP is a quack. I’m sorry, but this is a quack credential, even though it takes college, its is all about BS. That would make me say no to them, right there, but thats just me. I’m not into CAM, you may be, and that is your right of course. NEVER let one use OB tools (vacuums,etc)! They aren’t trained for it.

In short- You are taking a risk with your baby’s life (2x for CNM), and their brain function (18x more HIE at HB!!!). Still- You will probably be fine. The odds ARE with you. Even high risk moms with prior issues have a great chance at everything going well. Do all the prenatal testing, opt out when you have any complications, don’t go postdates, and you will be on the better end of those odds.

BEST LUCK
Sorry for the Teel Deer

Jessica S.

My sister-in-law had a totally uneventful pregnancy, labor and delivery with her first. He was having troubles breathing and they had to take him straight to the NICU. He only stayed for a few days – I think it was an air pocket outside his lung or something like that? She says that experience alone kept her from ever considering a home birth, or even a birth center not affiliated with a hospital, b/c she’s sure she would’ve lost him or that he would’ve suffered long term damage.

And who knows, maybe he would’ve been fine. But my point – and the point she makes as well – is that you can’t predict a healthy outcome for baby based on past healthy pregnancies/deliveries. The risk may be small, but that singular life is not.

It’s just an anecdote, but I wanted to offer it just the same.

Kwehrheim

I’m glad you look into both sides of issues. Having said that, your usage of the term “naturopathic doctor” is inaccurate. There are naturopaths, and there are doctors. They are mutually exclusive.

Who?

How about when no one has been able to identify, perhaps for years, what is wrong with you, but the alternative practitioner knows, with absolute certainty, within half an hour of you coming into their office/shop/wherever. Though they may need to verify with a multitude of tests.

Young CC Prof

That depends on whether this practitioner is right or wrong, which might depend on how accurate and objective the confirming tests are.

Stacy48918

Then that’s another flag of a quack.

Adelaide GP

I think that is part of the reason why people with non specific symptoms , or somatisation disorders of varying expression, have so much confidence in the quack practitioner. Doctors will be honest and say it’s not clear or say what the patient doesn’t want to hear ( eg somatisation) but the quack will act with absolute certainty and make up an explanation that gels with the persons fears or beliefs. All at a premium cost , of course. It may be more acceptable to hear “adrenal fatigue” and here’s the tonic, than “existential unhappiness ” and no easy fix for that, I’m afraid. It’s all in the spin and the charm and confidence with which it is delivered, that provides assurance and relief for the patient. Patients that seek their services want certainty and reassurance, and they won’t get that from a doctor that is viewing their symptoms through a biomedical or even psychosocial explanatory framework.

staceyjw

And because of this, they often do feel better, even if they aren’t. The placebo effect is the only think alt med has going for it, but it only works with some things. Try to cure cancer with it and that won’t end well.

Sue

All therapy has the potential for benefit via placebo effect – that’s why pharmaceutical medicine has to be tested as effective BEYOND placebo.

So why not attend an empathetic doctor, use effective therapy, and get the placebo benefit on top or real therapeutic benefit?

Sue

This is a real irony, in an era when informed patients want their doctors to involve them in decision-making, be honest and not paternalistic. It seems that something deep inside us craves that certainty we felt in childhood: “this is what’s wrong and I”ll make it all better.”

Many alt med providers are paternalists who are very good communicators and help their clients feel that they are bucking the system while paying for scam, simplistic advice.

I’ve heard it before: “none of the doctors knew what was wrong with me, but the (insert sCAM provider here) knew straight away!”

The Bofa, Being of the Sofa

I’ve said this before, an important difference between regular doctors and alt-quacks is that the quacks have no qualms lying to you. Ask a doctor, and they will him and haw, and never really give you a good answer. Because, in the end, they don’t know.

Quacks, OTOH, will give you a confident answer and tell you that they know what your problem is and how they can cure it. They are lying through their teeth, but hey, it sounds good.

And people like that.

Who?

Maybe it’s about how messages are delivered too. A doctor who says ‘I have no idea what’s wrong, but I can see you aren’t well and this is what I propose we do’ gives a lot more confidence than a hummer and hawer. Of course once you’ve been through a few processes with no end in sight it gets a bit tedious, however.

Sue

Has anyone ever been to a homeopath or naturopath who said “I think you’re doing just fine and there’s nothing I can offer that will make you any healthier”?

Who?

Like those women at the beauty counter-doesn’t matter how much exfoliating, moisturising, sunscreen wearing you do, there is always one more (at least) thing they can sell you that will make all the difference.

I love makeup but really tire of the micro/quantum this and that stories around the ‘skincare’ products.

staceyjw

Followed by pricey supplements, and weekly visits for “adjustments” forever. Full price, cash or check.
And they say docs are greedy….

Lori

Good list, I would also add that they like to sandwich bullshit claims between reasonable ones. Its always like, “stay hydrated, avoid wearing dark colors because they drain positive energy from your aura, oh and snack on fresh fruits and veggies!” I actually read that list or something similar off the back cover of a Kevin Trudeau book years ago.

LibrarianSarah

I’d like to add an anti-intellectual red flag. Quacks and denialists love to down talk people real educations on their subjects of interest. This usually occurs with liberal amounts of Dunning-Krueger giving us something like:

“Stupid doctors (psychiatrists, climate scientists, biologists, an what have you) think they know everything because they spend all there time with there noses in books. Real knowledge comes from experience. I have the street smarts and investigative skills to find out the TRUTH!”

This is also a great marketing tool because it plays on our cultures insistence that everyone with an advance degree is a bumbling “ivory tower” type that is completely incompetent outside of there own narrow and irrelevant field of research and can’t so much open a pickle jar on their own. Anti-intellectualism can also take a darker turn if you add some conspiratorial thinking and the bumbling professor becomes a mad scientist.

Adelaide GP

Another thing quacks have in common: they create an imaginary problem ( eg a spinal subluxation or systemic candidiasis or lazy pancreas or whatever) that only THEY can supply the solution to, at a significant cost of course. Very clever business model that I would admire in its audacity, if only I wasn’t disgusted at the complete lack of ethics. They create more work for me too, I suppose : , it’s not an uncommon scenario for a patient to present in a high state of anxiety with an alarming “diagnosis” that they want me to confirm or disprove. I’m always amazed though how little I get paid , in comparison to the quack, for the same issue!!

Wishful

I often wonder why these folks that are not concerned about money, and blame the evil greedy medical establishments for not caring about health and wanting to keep people sick for their wallets sakes don’t work for free! After all if a doctor is evil because they get paid by sick people who want to get well, aren’t they doing the exact same thing?

Bombshellrisa

Then they really should question the midwives! Cause if pregnancy isn’t a disease and a woman is designed to give birth, what is everyone shelling out $4500 for a midwife (plus another $899 for a doula) to do?

Young CC Prof

Aid in providing a pleasant experience, of course. And perform the quasi-religious ritual of natural birth.

Aj

That is because GP’S in Australia are an absolute waste of time, I have been to 6 different gps, 2 gasteroenterologists, a neurologist, a dermatologist for gut/anxiety/acne/energy/neurological problems i had for 6 years under the care of the above 10 different people. After two years of treatment i am close to what i was like 8 years ago before it all started going pear shaped. Oh course 2 years ago i started delving into natural medicine and was lucky enough to find a very good naturopath who is also a nutritionist who treated me with targeted supplements. I also tried Chinese herbal medicine but that didn’t really help.

Who?

I’m sorry you’ve been through that Aj. I understand your frustration with the medical establishment, particularly when you have multiple complex issues. That said, my family has had good relationships with doctors over the years, relying on mutual respect to work towards diagnosis and treatment. If I had been dealing with so many people and couldn’t get on with any of them, I might start to wonder how I was contributing to the relationship breakdowns.

Alternative therapists are well known and recognised, including by doctors, as having time to spend with their patients-time the current system for doctors in Australia discourages them from spending. Doctors have bills to pay and a living to make, and manage their practices accordingly. Alternative therapists have bills and a living to make as well, but enjoy significantly lower overheads, including insurance, so the commercial imperative takes on a different complexion for them.

My concern with the path you are on is conflict of interest. For instance, does your naturopath charge for appointments? Does the naturopath sell the products they recommend you purchase? The answer to the first could be yes or no; I’m confident the answer to the second is yes. So the more you buy, the more new things you have to buy as your condition evolves, the better off that person is. Do you think your naturopath will ever ‘discharge’ you?

It’s also likely that if there is a nutrition element to what you are doing, you’re eating fewer refined foods than before and may have even cut out food groups-gluten and dairy are the usual suspects. Everyone feels better eating fewer refined foods, and cutting out food groups means you are likely eating less overall, with a greater emphasis on fresh food, again not a bad thing.

I’m glad you’re feeling better, and I’m sure you have reflected on your experiences, but it’s important to acknowledge that there is likely to be many more things going on than ‘doctors are hopeless’.

Adelaide GP

So how does your naturopath explain your symptoms, if you don’t mind me asking.

Sue

”Aj” – this is either very good satire, or…

KarenJJ

I agree that GPs are a mixed bunch. I am now incredibly fussy about doctors and when it comes to one child if I have any doubts I just take her to emergency at the public hospital her specialists are based at. Due to the rare underlying condition and odd medication she’s on she seems to attract a fair sized bunch of specialists and registrars just out of interest.

I have a periodic fever syndrome – one of those one-in-a-million things – that causes all sorts of random bizarre symptoms that come and go. I’ve heard of one family where it is rife and who are still largely unaware of it who have had all sorts of issues with drug addiction and mental illness. People are trying to get in contact with everyone to let them know.

When I finally had a name for what I had, I was absolutely blown away that one thing could describe everything that was going on. My GP was also very, very surprised as I presented as a mostly healthy person with a few “allergies” and quirks. I ended up in the office of a very good Immunologist and from there he worked out genetic testing, medication and even went so far as to write a paper on it and the title was about how difficult it is to diagnose.

It’s incredibly difficult to keep pushing on when you’re being told it’s “all in your head” (one patient I know was referred to a psych. for her odd symptoms that didn’t match). It’s incredibly difficult to have symptoms that don’t match the expected and I think doctors could do a lot better at listening to patients and asking more open ended questions such as “how does your skin feel?” instead of “is it itchy?”. And follow up – the answer to anaemia can be “iron tablets” but there should be follow up to check that they are actually working. I had pretty much given up on medicine. I didn’t bother with alt-med much either apart from killing time while infertile and waiting to start IVF (basically I trusted alt-med even less then medicine).

So best of luck, I know it’s a very rare thing I have and might have nothing to do with your situation but my story is not an uncommon one amongst those with rare diseases. To be honest, when I tried alt-med that one time it also didn’t work much. The fact that a “naturopath” managed to clear it makes me suspicious that it was going to clear anyway for you, or that you go through a period of “remission” like I regularly had with my flares.

Sue

Hi, Karen,

It is not uncommon where I work to come across a situation I could describe as ”your symptoms just don’t fit any patho-physiological pattern I am aware of”. I don’t think a psychiatric consult should be considered unreasonable or insulting, as sometimes there are somatosisation factors that do affect symptoms. The psychiatrist should then some back with an opinion – either there are signs of a psychological issue or there aren’t. Sometimes there are psychological issues occurring as a result of the undiagnosed symptoms.

I’m really glad you found your way to the right expert. Of course your intellect and common sense didn’t allow you to fall for the woo, but many others do.

Mark

Lazy pancreas! That’s it! You’ve found the answer to why I want a nap every afternoon. All these years, when 3:30 rolls around and I have my daily sleepy spell, I thought I was the helpless victim of the sleep fairy’s relentless predation. Now I see that my lazy pancreas has been the real culprit all along. I shall henceforth give it some caffeine to wake it up in the afternoon

Cherylcgj

Natural medicine saved my life. Allopathic medicine almost killed me. Both fields of medicine are valid.

“Natural medicine” should stop hiding behind the quackery protection act (I don’t recall the real name but the law that exempted herbs/vitamins/etc from FDA oversight) and produce some hard data to back up its claims. For stuff that is so completely awesome they really don’t want to prove it.

Do you believe in magic?

An Actual Attorney

I do. In a young girl’s heart. How the music can free her, whenever it starts.

I often wonder how many of these kinds of cases are actually more of a reflection of lack of mental health care especially in the US, or our reluctance to refer that way. I mean how many of the “natural medicine saved me” stories have a narrative that goes like this.

I was sick, feeling horrible. Went doctor to doctor they did test after test and never could figure it out never found anything wrong. No medication worked, and all I got was side effects. Finally I tried a natural careprovider. They were caring compassionate and listened to my problems. They understood me and gave me something and suddenly I am better.

The medicinal substance given may not be effective, but I think having someone to talk to about your issues, especially if you are alone or isolated can have tremendous impact on someones life and even how they feel.

AmyP

“…lack of mental health care especially in the US…”

And just plain loneliness, actually.

Wishful

I have often thought there ought to be a medical specialty for lonely people who just wanna talk to a doctor.

ForgetfulGuest

Counsellors/therapists? I know I’ll be seeing mine this week because I feel lonely and can’t get anyone IRL to just listen to me for a few minutes. I guess people don’t necessarily realise that they don’t have to have a tricky mental health issue to make seeing someone like that worthwhile.

LibrarianSarah

Wait! Wait! You forgot your parachute!

http://gamesgirlsgods.blogspot.com/ Feminerd

By definition, I begin
Alternative Medicine, I continue
Has either not been proved to work,
Or been proved not to work.
You know what they call alternative medicine
That’s been proved to work?
Medicine.
-Tim Minchin, in his poem Storm

Natural medicine can work. There’s all sorts of active ingredients in herbs and things. But usually, we don’t know if it works, what the best dosage is, what the negative side effects are, etc. Get it tested, and it moves into the realm of allopathic medicine, which is, after all, natural medicine that’s been proved to work (where do you think aspirin, penicillin, and tamoxifen come from, for instance? Willow bark, mold, and tree bark).

Sue

And what do we call plant-derived medicines that have been purified and dose-standardised for a reliable effect? Pharmaceuticals, of course.

Oh, I fell for the blood type diet idea for years. I still find myself thinking “and that’s a great food for Type Os”. Argh. Of course, I legitimately did feel better when I paid attention to what I was eating.

Now let me separate that last statement from the diet. I feel better when I pay attention to what I’m eating. That’s the big secret.

Stacy48918

A lady in my church asked me about the blood type diet. I’d never heard of it but told her the idea was rubbish. The antigens on your red cells have nothing to do with your digestion.

Sue

If people ask me my blood type, I say I don’t have one. Oops – sorry – it;s a star sign I don’t have – I DO have a blood type.

Trixie

No Zodiac sign here either!

KarenJJ

Good answer

Bombshellrisa

I understand. I had looked into it too, I was curious. My diabetic mother asked about the diet because she heard it was good for weight loss. And guess what the diet is for Type A blood? Carb heavy with very little protein.

http://www.antigonos.blogspot.com/ Antigonos CNM

Remember that Geritol has/had a high alcoholic content? So do some of Bach’s remedies. My husband once drank a bottle [admittedly a small bottle, as the dose was supposed to be a few drops] by mistake and was exceedingly blithe for quite a while.

Mishimoo

Hah! That reminds me of a lady who brought her excitable mini poodle into my old work. Both ‘needed’ a fair dose of Rescue Remedy before coming to see the vet, and the lady insisted that we should sell it. She was not happy when it was gently suggested that giving herbed alcohol to a dog is not a good idea.

Jessica S.

Not that we would like details or anything. You just wanted to stick it to someone?

http://www.antigonos.blogspot.com/ Antigonos CNM

It’s known as the placebo effect. Or just time. Certain varieties of ailments are more amenable to benign neglect than others. You wouldn’t want to treat cancer or a broken leg with “natural” medicine, but a lot of forms of gastro troubles due very well with a simple reduction in stress, and menopause usually resolves itself over time.

Another clue: the more disparate conditions a ”remedy” claims to treat, the less likely it is that it treats anything.

DasFizzicker

Just one point to an otherwise great article: there is not ‘degree’ which you can get in quantum mechanics or chaos theory. The relevant field for the first is physics (anyone with even an undergraduate degree in physics has had to pass at least two semesters of quantum mechanics) and the second is mathematical physics/theory of differential equations. So basically if the person is a (reputable) physicist or (perhaps) mathematician, they probably know what they are talking about but otherwise it is a good chance they do not. In order to determine reputability, at least for a researcher, a good diagnostic is to look on arxiv.org which is a website where most working physicists publish preprints of their papers. If the person is not found here (e.g. Fritjof Capra) or if their latest paper was published a long time ago (e.g. Michio Kaku) they are probably not reputable/not reputable any longer

actualphysicist

Only some fields of physics routinely publish in arxiv.org. however you are correct in that they tend to be theoretical fields, which could certainly include quantum mechanics and chaos. In my experience, experimentalists are much less likely to put their papers in arxiv. That could certainly include experimentalists who work on chaos and QM, although I don’t work on either so I haven’t looked at this specifically.

Google scholar is a free way to search the scientific literature that is more comprehensive than arxiv. Pubmed is another good alternative but not all physics and math journals are indexed on pubmed.

Adding to the confusion, while there is a lot of good work on arxiv it is not necessarily peer reviewed. In theoretical fields close to my own it’s common to publish on arxiv but also publish the same work in peer-reviewed journals, since those “count” more. My understanding is that not all fields of physics do this, but again I haven’t looked at this.

While I’m here: a long time ago Dr Amy said that reputable journals had impact factors in the double digits or high single digits. This may be true for medicine but it’s not true for physical sciences. A perfectly respectable physics or chemistry journal could have an impact factor of 4.

Elaine

The other day my husband went to a doc-in-the-box clinic for a sinus infection, and was treated to a discussion by the NP about how whole-food vitamins are the only ones that work and synthetic ones aren’t recognized as food by the body. He was sitting there thinking “ummm, they’re all chemicals, and so are absorbed the same, isn’t that kind of the point?” He has no medical training, just common sense.

Sue

Your husband was spot-on, but, for interest, there is also doubt about what constitutes a bacterial sinus infection and whether antibiotics are indicated as opposed to just sinus-clearing strategies.

Elaine

Yeah, don’t get me started on that! But I can’t very well forbid him to go.

fiftyfifty1

Sinuses are one topic where those of us in medicine could do a much better job. I think one of the issues is that unless a person experiences a tendency toward reactive sinuses themselves, it can be hard to understand how severe and miserable the symptoms can be and still not be a bacterial infection. Those that have normal sinuses that aren’t as reactive and drain easily think “Well I would never complain so much or come to the doctor with just a cold, so maybe this guy has a bacterial infection”. Also, people with reactive sinuses actually DO go on to progress to more bacterial infections than those with easy sinuses if their congestion isn’t managed.

I myself have reactive sinuses and what finally worked for me is the following when I get a cold. Since starting this I have needed an antibiotic for my sinuses only once in 15 years.

Morning: Take a hot shower + 2 Aleve (naproxen) + 2 regular sudafed (those you have to show your ID to the pharmacist for) + 2 squirts Flonase each nostril +/- 1 claritin if it is also allergy season

You can use oxymetazoline for 6 nights in a row max or you will get rebound congestion when you try to stop it. You can’t use sudafed if you have significant hypertension. You can’t use Aleve (and will have to substitute Tylenol) if you have impaired kidney function.

KarenJJ

“sinus-clearing strategies”.. I think my toddler has a few strategies he could share…

Robert Kiser

3.5/6 isn’t bad, however the claim that all toxins are figments of the imaginations is bizarre and not mainstream medical thought. Toxicology is a valid medical discipline. The red flag is not a claim of “toxins,” lead and mercury, for examples, are indeed real toxins, but usually a neglect of not considering dose-response relationships and a tendency to be alarmist and absolutist when there is insufficient evidence to cause concern (BVO discussed by Romm is an example of the latter). Heretical geniuses have contributed to the advance of science, albeit rarely. Two examples would be Semmelweis and his “heretical” view that doctors should wash their hands and the Australian researchers who discovered that helicobacter pylori was responsible for stomach ulcers. Admittedly this does not happen frequently. I would also question the flattery flag. Such “us-against-them” bonding is also prevalent in the skeptical community, for probably some of the same reasons… Minority opinions have to persuade others to follow precisely because they are minorities. It would be nice if physicians really were all about the best evidence, but the fact is we do a lot of things for what we believe are pragmatic reasons, tradition, or because experts assert a strong opinion.

Young CC Prof

I would say that great fear of unspecified toxins is a good red flag. As in, “This product detoxes your liver from all the toxins of modern life!” If an article lists specific toxins, then the reader needs to get a whole lot more careful about whether the fear is plausible or implausible, like looking at how large the dose is.

Yes, there are heretical geniuses, but the vast majority of people who claim to be heretical geniuses are not. In fact, the vast majority are liars or crazy. So if you’re not an expert in the field, and you don’t have the ability to fully evaluate the claim, it’s probably safest to ignore all of them, especially if THEY have no relevant background and/or are selling their “secret miracle cure” direct to the patient.

Trixie

The difference is, these heretical geniuses produced reproducible results validated by other scientists. Hence, it was science. And eureka! the scientific establishment adopted these findings when they were proven correct.

Montserrat Blanco

Type timeline of helicobacter pylori and peptic ulcer disease in Wikipedia and you will clearly see that those “maverick” doctors were nothing of a such. They were following a research line decades long and they made great discoveries BUT they were not heretical at all. They followed previous discoveries, they followed scientific methodology and they published their research in prestigious peer-reviewed journals. I would not call a breakthrough discovery published in The Lancet (NEJM, Nature, etc) heretic.

Young CC Prof

People might have scoffed at the H Pylori theory back when it was a hypothesis but, most gastroenterologists adopted the antibiotic protocol quite readily as soon as solid evidence was presented. There was a CURE for some of these ulcer patients, one who’d suffered severe pain for years? There were truly reliable ways to prevent people from perforating and bleeding to death? Astounding!

The people who took the longest to accept the new theory were the ones outside the establishment, laymen and sometimes doctors in other specialties. Because they couldn’t evaluate the new evidence, and because everyone knew that ulcers were just stress, it agreed perfectly with their notion of the universe.

Now, Semmelweis was harder to accept perhaps because it required doctors to admit that they had not just failed to help but actively caused harm to a great many people, albeit inadvertently.

I cannot, however, believe that there are any other similar screwups still ongoing within real medicine, not on anything remotely like that scale. There’s just too much data collection out there. (The exception, of course, is snake oil sales, that is, “herbal supplements.” Not only do their makers fail to collect data, they run and hide when anyone else attempts to.)

Aussiedoc

Semmelweis was harder to accept because he was MAD. He couldn’t dessiminate the information. As soon as the evidence was presented – things changed, the end.

Semmelweis wasnt anymore a maverick than anyone else. He just couldn’t get the info out there.

PrimaryCareDoc

Regarding “heretical geniuses” in medicine- Why is it that people can only come up with Semmelweis and the H.pylori guys (who really followed the scientific method to a T and were not heretical at all)?

So, we’re talking about 3 people in the history of modern medicine, out of thousands of modern-day quacks. Not a great record.

Sullivan ThePoop

As well written as this post is I have to say there are few problems with it. For one, as scientists and doctors none of us has ever claimed that nothing is toxic so that is just a straw man. The problem is all the detoxing advice. Also, there is something heretical about Semmelweis but not having to do with hand washing and ulcer research was going down the pathogen road for over a decade, nothing heretical there. The later part is true for anything expect in the sciences being the minority when you are in the right is just the place you want to be.

islander2010

I’m with you on everything but #4, toxins. I fail to understand your denial that toxins exist simply because they’re not visible to the naked eye. Mercury in our seafood and in the prevailing winds that bring us yet more mercury from the coal-fired plants to the west of us… high ozone levels from increased tourist traffic along the coast in certain weather conditions… clouds of glyphosate as crops are readied for harvest… neonicotinoids and other pesticides that coat conventional produce (including systemic pesticides that can’t be washed off)… the fragrances in laundry detergents and fabric softeners that sicken me so much that I can’t walk down the supermarket laundry aisle… Do you actually question that these exist, that many of them are carcinogens, that at the very least they compromise our immune system? Seriously?

Stacy48918

I would imagine that some/many of those things you list actually have scientific data behind them to demonstrate their risks.

That’s not what she’s talking about with regards to quacks and their use of “toxins”. Quacks read the ingredient list, find some word they don’t like and scream that it’s a toxin and try to ascribe a myriad of negative effects to that singular ingredient. Yet there is no scientific evidence for a single shred of their claims.

That is what she means by the quackery claim of “toxins”.

Richard LaRouche

Roundup

S

Rodeo

MLE

Rawhide

S

I was playing active ingredient versus brand name — you got me; i actually googled to see if there wasn’t a formulation named Rawhide.

MLE

I thought we were doing western-themed words starting with R.

Young CC Prof

There was an antivaxxer who found “sucrose” on an ingredient list, didn’t know what it was, looked up the MSDS sheet and got terrified. It was hilarious.

MaineJen

OMG OMG OMG it’s…sugar

Jessica S.

When I think of “toxins” as it relates to pseudoscience, I think of “cleanses” and the need to “detoxify” the body. The body already has a detoxification system and short of a balanced diet and reasonable activity level, no extra “fast” or “purge” or whatever is necessary to get rid of these “toxins” that surround us. Usually, when people promote such regimens, the “toxins” the discuss are vague. Or are not harmful to the body, either at all or in the concentrations to which one is customarily exposed. But I won’t speak for Dr. Amy’s line of reasoning, she’s much more qualified to speak on it than myself.

islander2010

I fully agree. I think procedures like “colon cleanses” are pure nonsense. The fact remains that we are exposed to a number of toxins in our environment and in our food, the majority of which we remain ignorant of. Combined, they exercise a profound effect on human health. Check out what countries are leaders in obesity, just as a starting point. Contemplate what factors may be implicated in this nearly worldwide trend. Anyone as old as I am has seen movies from the 40s and 50s where actors and extras were always slender, i.e. normal. We don’t know what normal is anymore. We’ve come to accept that plump kids are healthy and that fat people are merely “big and beautiful.” Do you not wonder how and why this happened?

Young CC Prof

I don’t wonder how obesity became an epidemic, and I don’t need toxins to explain it. Sedentary lifestyles, and high-calorie foods cheaper and easier to eat than vegetables.

And no, people were not this sedentary in the 50s. Most families had one car, not two. Children walked all over the place. Fewer appliances in the kitchen, and heavier ones. No automatic garage doors, remote controls, etc. Typewriters are more work to use than computers. I could go on and on.

Trixie

No it was MONSATAN and the chemikills!

Jessica S.

My thoughts precisely!

Jessica S.

I assume it has a lot more to do with sedentary lifestyles than chemicals and toxicants. Also, technology has just made life easier and more automated. You have to be more intentional about moving about.

Irène Delse

“We’ve come to accept that plump kids are healthy and that fat people are merely “big and beautiful.””

You mean that we’ve come to accept theses things again? Because until quite recently, chubby kids were considered healthy. Look at vintage ads from before WWII, or even the ’50s, and you’ll see plump, red cheeks on kids, plump arms and legs, round stomachs… And if you look at paintings of children from 200 years ago or more, they often seem nearly apoplectic. Pretty women of that era were also famously more rounded than what passes for acceptable today. Just look at Rubens’ beauties… To be fat meant well fed, prosperous and enviable. Even in the 1950s the trend toward slenderness wasn’t totally dominant. Try comparing Marilyn Monroe, or Sophia Loren, with Nicole Kidman for instance, and you’ll see how standards of beauty have changed in time.

Trixie

Marilyn Monroe was actually tiny, though, by all accounts.

Sullivan ThePoop

That is true too. Actresses from the 40s and 50s were usually not very thin.

Trixie

They were still very thin, just slightly less thin than today.

Sullivan ThePoop

I live in the US where there is a lot of obesity. I am very thin because I eat a healthy diet, exercise, and have good genes for it. My husband on the other hand is heavy because he eats a lot of fast food, doesn’t exercise, and has a family history of weight problems. If it was toxins we would both be heavy.

Trixie

Dude, first of all, laundry fragrances may be annoying but they’re not carcinogenic. That’s just silly.
Roundup has been thoroughly studied as a dessicant and doesn’t pose a threat to human health when used as directed.
The levels of pesticides in produce haven’t been shown to be harmful to human health.

S

From the commenter’s description, it sounds like the herbicide is being applied in an illegal fashion, if it is drifting off the intended spray area.

Trixie

In which case she could contact the state authorities and ask for an investigation.

S

Agreed.

islander2010

I’m trying not to laugh. Glyphosate is being routinely used for this purpose across the country. Any study testifying to its safety in this or any other respect has been produced by… guess who? When it first appeared on the market we were promised that it was safe enough to drink. Innumerable birth defects in both livestock and humans have testified to the inaccuracy of Fox-in-the-henhouse “studies.” I testified before our state Agriculture committee about this topic… I’m sure you can guess how my testimony was received, along with others… I am frankly surprised at so much ignorance at how our food supply has been tampered with. Please, do some independent research. You could start with Samsel & Seneff.

S

Well, you’ve got my interest, if you’d like to explain. Used for what purpose? Why would crops be sprayed shortly before harvest? I don’t have nearly enough background knowledge to comprehend those studies, sorry.

S

Ooh! Ooh! Brilliant heretic flag! Did i get one?

Trixie

To dry them out more quickly so they can be harvested with less waste of risk.

S

Thank you! (I don’t know much about agriculture. I use herbicides in habitat restoration.)

Trixie

Yeah, you can Google it and find all kinds of guidelines on when and how and on which crops.

Trixie

Of course it’s being routinely used as a dessicant. Is that supposed to surprise us? No one’s made a secret about that.
Could you link to the transcript of your testimony?
Where’s your causal link between glyphosate and birth defects?

Jessica S.

“Any study testifying to its safety in this or any other respect has been produced by… guess who?”

In other words, big conspiracy?

Sue

The natural world is full of toxins – from peanut aflatoxin to the various alkaloids in plants from castor bean to macrozamia nuts and lupini beans to puffer fish – all edible if you know how to detoxify, dangerous if not.

From the industrial age, various people were exposed to coal dust, mercury and lead in many settings, and agriculturally to DDT, organophosphates and paraquat. Many of these now eliminated or markedly reduced in the developed world. We have merely shifted our concern down to a safer range of chemicals.

Meanwhile, longevity and standard of living (in our wealthy societies) continues to improve.

Sullivan ThePoop

I am trying not to laugh that you would use Samsel & Seneff, researchers in different fields who make things up about nutrition.

The Bofa, Being of the Sofa

I have been thinking, run islander’s comment through Marni’s quackometer. Conspiracy, referencing non-experts, special knowledge (see, we are ignorant), yep, that’s quack.

Young CC Prof

I think it’s some kind of law of the Internet (maybe it needs a name) that whenever someone writes an article about the hazards of pseudoscience or quackery, a proof-by-example rapidly appears in the comments section.

The Bofa, Being of the Sofa

“case-in-point” as it were.

islander2010

Trixie, first, I’m not a dude. Second, people with MCS have a debilitating and sometimes life-threatening reaction to synthetic fragrances of all kinds. Third, I owner/administrator a wellness site, one of whose forums (on genetic modification) runs to 40 pages, 20 studies to a page, on the harmful health effects of glyphosate. Are you aware that it has been detected in human urine, blood and breast milk? Its threat to human health has been astoundingly well documented. Dream on if you choose…
Finally, I find it hard to hear your claim that pesticides have never been shown to be harmful to human health… because I can furnish heaps of evidence to the contrary. Tell me, are you familiar with the term, “toxic synergy”? Please, Google it.

Trixie

Oooooh you run a website. One with bibliography salad. Well, in that case, you must know what you’re talking about. Care to link to it?
The “study” about glyphosate in breastmilk was a complete joke. As I recall, it was conducted by some anti-GMO outfit, and requested that mothers mail in breastmilk samples. It wasn’t a blind study, and there was ample room for deliberate contamination. Two mothers’ samples had glyohosate in their milk, which is hard to believe unless they were simultaneously pumping and, like, servicing the crop sprayer.

Siri

Trixie, many farmers are forced to multitask in the current economic climate. My breastmilk used to contain Omega 3 from the fish fingers I fried while breastfeeding my youngest.

Trixie

Frying, you say? Hmmm. Well, I hope for your little ones’ sake you at least used pure kale seed oil.

Young CC Prof

Many substances are found in human urine, blood and breast milk, and other fluids for that matter. That doesn’t prove they are dangerous, or that most people are exposed to substantial levels.

During pregnancy, I was so hyper sensitive to fragrances that I went on a rampage and threw away every scented product in the house. I get feeling so sensitive to smells that you think they’re killing you, and how this could appeal to a lot of people.

KarenJJ

I remember wondering if I had something similar or not because of a bizarre reaction to hairspray – It turned out to be a rare auto-inflammatory syndrome. My eyes probably were getting inflamed from the hairspray but that was more due to the underlying chronic inflammation (which turned out to be caused by genetics – not “toxins”) then anything else.

Similar with vaccines – they can trigger a flare due to my underlying immune system issue – the problem isn’t the vaccines as such – but that my immune system is already switched on and adjuvants in vaccines dial it up even further. It’s not a reason to forgo vaccines but a reason to diagnose and manage underlying immune system problems.

Young CC Prof

I’m allergic to more fragrances, lotions and soaps than I can count. It doesn’t mean they’re “toxic.” Many people are allergic to peanuts, but they’re a fine nutritious food for everything else.

The Bofa, Being of the Sofa

I was thinking this as well. Even if it were true that there are people with MCS that react badly to such things, how does that make them “toxins”? Peaches make me puke. That doesn’t mean they are toxic.

I’ve heard the “some people are allergic to X ingredient, so don’t use the product” thing a lot of times and it never makes sense.

Young CC Prof

Actually, that’s kind of the argument behind the “quack attack on Glucola.” It makes some pregnant women feel sick, therefore it’s toxic. Never mind that the same could be said for any food product in existence…

PeggySue

hahahaha the first time I read this I thought you had written, “Preachers make me puke. That doesn’t mean they are toxic.”

Sue

PEGGYSUE IS BACK! Missed you!

Sullivan ThePoop

I think it is weird that people who are allergic to peanuts often have cross reactivity to tree nuts and not legumes.

Siri

‘Wellness’ – nother red flag. I hate that word.

Kerlyssa

The smell of popcorn sends me from fine to urp in about 5 seconds. New line of research for you! Also- the taste of tomatoes. Ketchup is ok though, so something in the ketchupification must remove toxins. New forum thread?

UKdoc

It is really important to judge a source and avoid all quackery but reading the comments I am a bit worried that certain medical practice which is common in the Uk and has been peer reviewed and cost analysed is being dismissed as quackery. The beniifits of breast feeding is one huge studies have been done focusing on the beniifits I agree some woo pedlers take it too far. Midwife led births is another. I get in the States Midwifery falls into the category of quackery but the Uk and other countries train midwifes to a good standered and our births are just as safe. Studies have shown VABC is safer than a c section but most OBs in the US claim they are too unsafe. I think sometimes looking at what a country with a non profit health service is doing to get a better in biased view. The studies are there and peer reviewed but some Drs in the US ignore them. I really really hate quackery and victim blaming I have Crohn’s and want to punch certain people out on a weekly basis but jumping on things that other countries do as normal practice not as quacks is a bit off. Birth with minimum intervention doesn’t have to be plant a placenta hippy dippy nonsense.

Jessica S.

“Studies have shown VABC is safer than a c section but most OBs in the US claim they are too unsafe.”

That’s a pretty vague statement. It may be less risky for SOME women (of course, no one knows for sure until the trial of labor results in a successful VBAC). It’s absolutely riskier for other women. It may also be a near draw as to which has less risks, and thus should be up to the woman how she wants to proceed. But if there’s one thing for certain, it’s that a blanket policy on VBAC is not reasonable or safe. It has to be assessed individually, and yes, assessed against the best research available to date, but ultimately the decision must made on the individual patient alone.

Stacy48918

“It may be less risky for SOME women (of course, no one knows for sure until the trial of labor results in a successful VBAC). It’s absolutely riskier for other women. ”
This is the biggest thing. Whatever the white papers say about the risk of VBACs as a whole, no one has a crystal ball pre-labor to know which woman will have a good outcome and which will have an absolute disaster. Low risk is not no risk.

Young CC Prof

Yes, there are no guarantees of a good outcome, but the point is that there ARE some women who can be clearly identified in advance as bad candidates for TOLAC. Women who are identified as reasonably good candidates have a 0.5% risk of rupture and a roughly 75% chance of successful vaginal birth, which isn’t bad as long as you’re doing it in the hospital.

Another woman might have a 10% chance of successful VBAC and 5% chance of catastrophic rupture. And then you get people like ICAN telling such a woman that everyone can VBAC and only ignorant cowardly doctors recommend against it.

Trixie

Yeah, in the event that a TOLAC results in a successful vaginal birth, the outcomes for both mother and baby are statistically great, even slightly better than a scheduled RCS. But, of course, the outcomes for a failed TOLAC are worse. So it’s a matter of being in a hospital with immediate anesthesia and surgery, and making sure you’re actually a good candidate.

Mac Sherbert

VBAC safer for who? Mom or baby? As I understand it C-section is the safer choice for the baby. Even with immediate surgery a baby is at great risk for HIE or death in the event of uterine rupture.

I’m not sure of all the stats, but when I was considering a TOLAC the safety of baby is what lead to me a RCS. Isn’t there a study that showed the baby has to be out in less than 16 minutes to avoid brain injury??

And what if the mom just doesn’t want to find out, if she is that 25% it doesn’t work out for?? I just do not like the idea that women should be forced to take even the smallest risk with their babies health when a RCS is perfectly valid option.

Trixie

No, I’m saying that once the VBAC is successful, and the baby is born vaginally, the outcomes are the better than RCS. Of course, you can’t know in advance if your TOLAC will be successful.
And I was in no way arguing for forcing anyone to VBAC.

Mac Sherbert

Trixie…Sorry, I didn’t mean to imply you thought women should be forced to VBAC! Clearly, you wouldn’t. However, there are those (Mothering boards) that do think that way!!

OldTimeRN

16 minutes? That can’t be right? It seems like an awful long time for a baby to be deprived of oxygen. Well the baby might be alive but with brain damage.

When a rupture is diagnosed it’s literally a race against the clock to open the OR, stat count the instruments, wheel the mother in, put her to sleep and deliver that baby.

Stacy48918

“there ARE some women who can be clearly identified in advance as bad candidates for TOLAC. ”
Oh I agree completely. I was thinking of those “low risk” candidates – even in that group there is no crystal ball that says which will be in that 5% rupture group.

My husband and MIL couldn’t understand my upset and fear over my SIL – Type I diabetic, primary CS for failure to progress, baby measuring 9+ pounds – trying for a VBAC with baby #2. I was terrified waiting for her to go into labor. As it went, her labor was FAST and she had an uncomplicated VBAC of a 10# baby boy…but oy…scary.

The “no crystal ball” is the biggest thing right now between my hubby and I. He wants a homebirth. I want a hospital birth. 2 prior term vaginal deliveries with no complications at all I’m pretty “low risk”…but I’m not “no risk” and so I will go to the hospital. Even if I go alone.

Mac

I think you could get some of us to go with you to the hospital in spirit. I’m sorry you are in that situation with your husband. Hopefully, he will come around.

Stacy48918

Thank you Mac. I appreciate that very much.

FormerPhysicist

Mac is great; I’ll be there in spirit. I suspect if you wish to reveal where you are, even in general terms, there may be someone who would connect in a less public fashion and go with you in physical, not just in spirit. I’m nearish Boston.

Stacy48918

Thanks. I really appreciate the offer and I will keep it in mind. I am in New England as well. I’ve got some time though…I’m not due until around the first of the year. Maybe I’ll have the hospital’s first 2015 baby.

staceyjw

Bring a smart phone, then we will really be there!
My DH wasn’t hostile or anything, but had nothing to do with anything up until the baby came. Its not bad at all. I hope yours isn’t antagonizing and just leaves you alone.

Stacy48918

“Bring a smart phone, then we will really be there!”
I don’t have a smart phone (hate the things actually) but I’ll bring my laptop.

“My DH wasn’t hostile or anything, but had nothing to do with anything up
until the baby came. Its not bad at all. I hope yours isn’t
antagonizing and just leaves you alone.”
For the moment, that’s where things stand. We’ve talked about it some more, mostly respectfully, and come to a truce of sorts. We’ll see how things go.

AmyP

That’s sad.

Why does he want a homebirth? The experience or financial? Or is he phobic about hospitals?

Stacy48918

For all the reasons discussed on this blog – he thinks it’s safer, is terrified of C-sections, thinks the docs will force us to do stuff we won’t, thinks we have control at home, thinks the midwives are so much nicer, thinks birth is natural, etc, etc, etc. He has said “show me the research that it’s more dangerous” and references MANA’s statement of safety…but then shrugs off the increased risk in Amos Grunebaum’s paper exactly as Dr. Amy said – an increase in a “tiny” risk is still “tiny”. *Sigh*

Seems it won’t be an “if” though…I had a feeling he was going to dis-involve himself and he said as much today. If I go to the hospital, he will not come.

Makes my heart very heavy…but I’ve done this twice before I can do it again. I’m looking into a doula service (all my friends are anti-hospital birth as well, family out of state).

Staying home for the last baby when I wanted to be at the hospital was mentally agonizing for me. I want to be where my baby will be safest.

Young CC Prof

I am sorry you are getting so little support from your friends and family right now. Ultimately, though, it’s your body and your child, not theirs. Even your husband has no right to make that decision for you, since he won’t be the one bleeding if it goes badly. Let us know if there’s anything we can do to help. Do you think he’s open to discussion, hospital tours, etc, or is it better to leave it be for now?

Stacy48918

I’m going to leave it be for now…but once I start going for prenatals (I’m 8 weeks now) I think talking about it will be even more difficult. His exact words were “I think it is best that I not pretend to be involved” and “this is your thing” (regarding scheduling first visit). I am glad at least that he acknowledged that it *is* ultimately my decision, however much he disagrees. And while I do want him there, if he’s going to be openly antagonistic to the staff then perhaps it is better he stays home.

Young CC Prof

If he wants to discuss it again, this statistic might be helpful:

Among women who have previously had vaginal births, with no history of c-section or other surgery on the uterus (That’s you!) the probability of c-section in the hospital is only 3%, assuming you go into spontaneous labor at term with a single head-down baby. Not the oft-quoted 30%, 3%.

Stacy48918

Thanks for the number. It’s nice for me to know it as well. I would imagine that most of the reasons for those 3% are the truly scary things too (i.e. not just “failure to progress” or “maternal exhaustion” like a primip might face)…so all the more reason to be in a hospital. He’s not interested in numbers – he feels that even if there is an increased risk outside of the hospital it’s still a “tiny” number and so he’s not worried about it at all.

Jessica S.

Oh, Stacy (or not-Stacy – wasn’t I going to call you that? I recall that from another post where someone was all upset over people knowing her real name. But I digress.)

I’m sorry that there’s conflict over the place of birth. I know it’s not an easy situation with no easy solutions. Like Mac said, we’ll be with you in spirit. I hope he has a change of heart, but I also know those are a lot of hurdles to his line of thinking, in order for him to get there.

Stacy48918

Thank you Jessica. That’s the hardest thing right now – we haven’t told anyone we’re pregnant yet so there’s no one in real life to confide this to and it’s very lonely. I appreciate having somewhere to air my thoughts.

-Not-Stacy

staceyjw

Tell your hub I said he is being a real dick. Refusing to be there for the birth because HE doesn’t like it? Awful. And ridiculous.
I would say the same if you wanted a HB, and he was against it.

The Bofa, Being of the Sofa

And if he doesn’t listen to Stacy, you can tell him that _I_ said he’s being a real dick.

Moreover, this dickness is going to cost significantly in terms of the experience.

You’re having a baby! It’s a time to celebrate, and try to enjoy it as much as you can. No one can do that if he is being a dick. He’s not going to enjoy it, and you aren’t going to enjoy it.

Why would he do that to those he loves?

Irène Delse

Oh, that sucks. He may not like hospitals, but it’s *you* having a baby, it’s your body and health directly involved here. I totally support you and hope you find a good doula. Maybe the hospital has a list of recommended providers?

Stacy48918

“I totally support you and hope you find a good doula.”
I actually found one that lives in my same town that I emailed last night. I’ll try to call her later this week. It’s a bit odd to think of paying a total stranger just to have someone there with me, but whatever.

Trixie

How’s it going on the vaccination front?

Stacy48918

It’s not. Though I am still going to get my own boosters when I can.

araikwao

The same applies to CS and its associated risks (playing devil’s advocate, here)

MaineJen

VBACs are relatively safe if you have immediate access to anesthesia and surgery in case of uterine rupture. Some hospitals simply don’t have those capabilities 24/7, and thus they do not offer VBACs. It’s about patient safety.

areawomanpdx

Yes, studies have shown that VBAC is safer…for the mother. Repeat cesareans have been shown to be slightly safer for the infant.

stacewyjw

While our system has big issues, State funded medicine has it’s own failures, of a different sort. One is cost controls that make doing nothing cheaper (even if its costlier later). In maternity care, this means lack of pain meds in labor, whether denial or because they aren’t available due to short staffing, less testing (no GBS?), and fewer interventions, use of MWs not OBs.

Too many of your MWs are woo pushers and while much superior to our CPM/lay MWs, are inferior to our CNMs. The Dutch model of MWery is dismal, with more deaths among low risk moms seeing MWs than high risk ones seeing OBs! Why? Lack of “interventions” and technology is a negative, not a positive.

Birth with minimum intervention that goes well is called LUCKY. When it doesn’t, well, blame the mom? This is nothing to brag about. NCB as a philosophy is total quackery, with its laundry list of BS claims.

I know our system has its issues, but for birth, it is pretty nice in most places. I would hate to see the UK or Dutch maternity model in the USA, what a mess that would be. You can bash our numbers and say I’m wrong, but I know they aren’t counted the same, and most use numbers including the entire first year, which is where our income inequality and such starts to show. Perinatally, we do very well.

And VBAC- brain damage matters, but this is rarely considered>CS is better for this.

Ash

I was thinking: I wonder if there’d be a place in this blog for upcoming posts about contraception? I don’t know if there are any significant NCB opinions about different contraceptive methods, or perhaps any potential blog posts about contraception that would be interesting to viewers. I think a post about permanent sterilization in relatively young people would be interesting, for example, as I know some “childfree” online communities often talk about the difficulty of getting permanent sterilization.

areawomanpdx

Well, Ricki Lake’s next documentary is anti-hormonal birth control. And cruncy mommies are often decrying the dangers of the Mirena. I agree this would be a very interesting subject for a blog post.

Mer

What pray tell is their problem with mirena? It’s a breastfeeding safe BC with super low dose hormones . . . . Oh wait there’s the answer, artificial hormones! Which are artificial and not recognized by the body so they are toxic and it’s why everybody gets cancer, did I get that all right? Oh and they can be passed to the baby ruining the baby’s pristine gut and causing immune deficiencies and that’s why they get sick even though they have the bestest immune system ever from exclusive breastfeeding and no toxic vaccinations!

Jennifer Nicole

To be fair, some people do have counterindications with Mirena. There can be some risk. I know my experience wasn’t harmful, but it wasn’t pleasant, either, which is why I only used it for a year.

Sullivan ThePoop

Yeah, my daughter has Mirena and it migrated and caused some not permanent damage to her cervix. My SIL got the copper IUD and it also migrated but didn’t cause any damage.

fiftyfifty1

I took the kids to science museum over the weekend. There was a great exhibit on quackery. My favorites included antique flasks of “energizing” radium water, but especially the Spot the Quack Quiz Show. The quiz showed short filmed pitches by 2 actors playing quacks. Periodically the film would pause and you could vote on what red flag the actor had just displayed. The first film was an Olde Timey con man selling radium water and was played in a very hammed up way. But the 2nd was a sympathetic, sincere, modern woman in a doctor’s coat selling a sublingual riboflavin supplement.
Two of the red flag options that they had which Amy didn’t include on her list are “Ancient Wisdom” and “Cure All”. We certainly see the first a lot with NCB: “tap into ancient mama wisdom” and “the knowledge about birthing that modern societies have lost but indigenous cultures still understand”. We see the second a lot with Lactivism: breastfeeding prevents EVERYTHING bad.

Alcharisi

Ooh, which science museum? Not that I want you to expose your IRL location, but that’s an exhibit I’d love to see.

fiftyfifty1

Google “science museum quackery” and the one we visited will be one of the first few entries.

Alcharisi

Thanks! It’s a bit far from my neck of the woods, but one of my best friends will be moving there shortly. I’ve already given her a mission to report back.

Ainsley Nicholson

Perhaps the best example of a “brilliant heretic” in real life would be Barry Marshall, who drank some broth containing helicobacter pylori in order to prove that it would cause gastric ulcers. And that exception actually supports what Dr. Amy is trying to say- Dr. Marshall had a lot of data to support his belief (it wasn’t just something he dreamed up). And once his data was available and supported by his rather unorthodox self-experimentation, the medical community embraced it (despite the fact that antibiotics are cheap, and I’m sure there were plenty of people making good money treating gastric ulcers as if they were stress-induced).

Who?

My daughter was very unwell all last year, lots of hospital admissions, drugs, specialists etc and when we got to the gastroenterologist (after appendix removal and lots of treatment for kidney infections that it turned out were not kidney infections) he scoped her and found h.pylori. One week and a $30 box of drugs and she’s well again.

Amazing. And a huge relief. And really cheap compared to the north of $5k we spent out of pocket having her investigated and treated, not to mention the misery and pain she went through.

Ainsley Nicholson

I’m so glad she was properly diagnosed and treated.

R T

I have a problem with number #2, we know our government carried out secret radiation experiments on thousands of people. One of the most disgusting being the project done at Vanderbilt University where nearly one thousand poor pregnant women were given radiation, but told they were taking “vitamins” so researchers could see how quickly radiation crossed the placenta. Several babies died from this exposure and many other were damaged. There was countless unethical human experimentations done on people without their consent and knowledge. How can you guarantee it’s not still happening somewhere? I feel the distrust and fear surrounding the medical community and science was unfortunately created by unethical practices of the professionals who came before. I mean people experimented on with out their consent or sterilized without their consent! These people are still alive today to testify to congress about what was done to them so it’s no wonder the public is suspicious and distrustful!

The Bofa, Being of the Sofa

How can you guarantee it’s not still happening somewhere?

How would that be the “giant conspiracy of the medical establishment” though?

You claim it was “the government” but how many people were actually involved and knew what was going on? More or less than 50?

Even if that were going on, it wouldn’t constitute the massive conspiracy of healthcare providers that is asserted.

R T

You mean in this one study I highlighted or the dozen going on in addition and the numerous eugenics boards including the notorious one in North Carolina? I believe thousands of people were involved. The entire government of North Carolina and dozens of medical professional certainly knew in that case. The unethical human medical testing was wide spread!

Sullivan ThePoop

Unethical medical experiments were actually less of a problem than no informed consent. Serious, look up some good medical history.

Ainsley Nicholson

I think the Vanderbilt experiments are an example of a small conspiracy, not a giant conspiracy. A small group of people can keep a secret and do a lot of harm, The example you note is disturbing for a lot of reasons, but it is not an example of a giant conspiracy to withhold life-saving information.
I’ll nit-pick a little…those experiments were government-sponsored but not done specifically by the government; the government has and continues to fund much of the medical and scientific research done in the USA. Also, you may be exaggerating the effect on the babies- papers published in the late 90s and early 2000’s found that the radiation exposure was minimal.
That said, I think you make a very valid point about past unethical practices still haunting the public perception of medical and scientific research.

Young CC Prof

I do believe that conspiracies exist. However, here’s my heuristic for distinguishing between plausible conspiracies and wacky conspiracy theories:

How many people would have to be involved to pull it off?
What kind of financial or other incentives might they get for keeping the secret?
Would any of them have a strong incentive to break open the conspiracy?

If it would need to involve thousands of people, many of whom are not very well paid, it’s not too plausible. If it would only require a handful of people, all of whom are getting rich, it might be possible.

islander2010

The Tuskegee experiment comes to mind…

The Bofa, Being of the Sofa

For what? You seriously think that the Tuskegee experiment was a conspiracy by the medical establishment?

Seriously, how many people do you think were actually aware of what was being done? More or less than 25? And how many of them were actually doctors? 10?

Ainsley Nicholson

I’ve read that a lot of people were aware of what was going on with the Tuskegee experiment- it was reprehensible but nowhere near from being a well – kept secret. Except of course from the people who were most directly effected.

Stacy48918

Many NCB quacks believe that the ENTIRE MEDICAL ESTABLISHMENT – every OB, every nurse, every hospital, every single one are involved in a massive plot to overly medicalize birth, drug every pregnant woman, forcibly give her an epidural, perform an episiotomy or C-section against her will, steal the baby away to the nursery and drug it with all kinds of horrible things. They seem to think OBs and nurses get some kind of sadistic pleasure out of these things.

Were there/are there nebulous things going on – I don’t doubt it and some are historically documented. But saying that because an unethical experiment took place years ago all doctors are involved in a conspiracy theory to harm pregnant women is a quack claim.

Montserrat Blanco

Even during the time those really bad things happened they were performed by only a handful of doctors. Most of doctors care about their patients and about ethics.

Ethic rules are much more strict now. Some things that you might have got away with in the past are strictly forbidden now.

We can not guarantee that unethical research is not being carried out somewhere in the world but the vast majority of medical knowledge today is gathered from very ethical research.

R T

The 170 sit general assembly in North Carolina implemented the eugenics board that was active until 1977. Then you have all the officials that carried it out, all the hospitals, doctors, nurses, cases works and thousands of people were involved in sterilizing poor child, women, inmates and any one else they deemed unfit. I think you are greatly underestimating how many people were involved in this unethical medical practices. It was beyond a “handful” many times over. In all the medical experiments and eugenics programs, the doctors believed they were helping the greater good so much it excused the great harm they were doing to individuals.

Montserrat Blanco

Assuming all OBs in that state were involved (difficult to believe) it was probably less than 2-3% of doctors of the state. The actual number of OB/GYN is 5% of all licensed doctors in USA. That is a handful definition for me. So, because 40 years ago because in one state of the USA a handful of people did something really wrong we should distrust all the medical professionals. I do not get it. 40 years ago it was not possible for women in my country to open a bank account without her husband’s permission. That was all the banking people at the time. I do not feel distrust when I go to open a bank account today. There were a lot of wrong laws 40 and 50 years ago.

Young CC Prof

I think the real problem there might be dehumanization of some members of society. If that’s going on, it usually extends way beyond the medical profession.

Jessica S.

Dehumanization of other people is a speciality in politics, particularly in foreign policy, but certainly in domestic affairs, too – at least, that’s my personal observation. It’s sad, because we seem to want to teach our children some version of the Golden Rule, but don’t expect any adults to keep to it. Now I sound like a peacenik hippy.

Alcharisi

Yeah, this. I mean, you read enough biomedical ethics and it can start to make you cynical about the whole enterprise, but I think it’s important to keep in mind that the dehumanization that occurs in medicine is a function of medicine existing within a society in which oppressive structural forces are deeply pervasive (rather than a characteristic that is essential to medicine itself.) Which, in turn, means that “alternative” health institutions also are prey to those same forces. (Consider the discussion of the victim-blaming that goes on in much alt-med.)
So alt-med can’t claim the moral high ground, either. In addition to, you know, not working.

Sullivan ThePoop

If you want to know how about medicine really changed you should read “the Immortal Life of Henrietta Lax” It is very easy to read and is about the very subject you are speaking of.

yentavegan

OT I had the misfortune of seeing the tv show called the Doctors this morning. Ruth Fowler was on talking about her awesome midwives and her home-birth success saga. Twas a cringe worthy ordeal watching the “real ” doctors kiss up to her…idiots are blinded by her outer beauty.

Trixie

Oh FFS. I hate that show.

Jenny_from_da_Bloc

She must have forgot to tell them the part where she almost bleed to death and had to go to the evil hospital and so the evil OB could save her life! Bet they didn’t talk about that part of her “successful and empowering” home birth. Gagggggg!!!

The Bofa, Being of the Sofa

Am I the only one who, after reading this post, wants to go ride roller coasters?

(at 6 Flags, of course)

Amy M

Great Adventure! Who’s with me!

Dinolindor

El Toro! Nitro! Batman! Yes! Errr, well, next summer anyway. Considering we once did a 10 day road trip to visit roller coaster parks – a different park almost every day, I can’t believe we overlooked the timing of roller coaster season when we decided to go for #2.

Amy M

Cool–my parents live right near there, we can crash at their place.

Dinolindor

That’s usually the motivation to get us to visit my parents in the summer, before schedules carry us off to the holiday season.

The Computer Ate My Nym

6 Red Flags over Quackery…Ride the Secret Knowledge coaster, where you’ll experience twists and turns, all completely in the dark! See the Secret Conspiracy haunted house where you’ll be menaced by evil doctors and Big Pharma! Stop in our numerous Flattery shops to buy souvenirs that look fabulous on you (trust us)! Ride the terrifying Toxin Water Ride (don’t get splashed)! The Brilliant Heretic’s high g-force loops will thrill you! The Quantum Gravity ride takes you to new heights–and drops you all at once!

Best of all, if the state shuts the amusement park down for a poor safety record, it just proves the conspiracy is true.

The Bofa, Being of the Sofa

de the Secret Knowledge coaster, where you’ll experience twists and turns, all completely in the dark!

Does it go upside down? I like inversions. And magnetic rails. Those are friggin cool. But no wooden clickity-clacks.

The Computer Ate My Nym

Maybe. You don’t get the Secret Knowledge until you’ve paid for the ride. It’s possible that it has inversions. Or maybe it’s really a Merry-Go-Round.

Young CC Prof

Secrets Big Amusement doesn’t want you know.

auntbea

Trust gravity. And acceleration.

Nathan

What you are describing fits completely the 9 patterns of the Narcissistic Personality Disorder NPD. Quackery happens when a person with a NPD becomes a health provider eg midwife:

Criteria for narcissistic personality disorder to be diagnosed include:

1.Having an exaggerated sense of self-importance
2. Being preoccupied with fantasies about success, power or beauty
3. Believing that you are special and can associate only with equally special people
4. Requiring constant admiration
5. Having a sense of entitlement
6. Taking advantage of others
7. Having an inability to recognize needs and feelings of others
8. Being envious of others
9. Behaving in an arrogant or haughty manner

They all fit

Zoey

The “appeal to nature” seems to be the biggest influence on my prone-to-woo friends. They question everything that doctors and other medical professionals say, but tell them something is “all-natural” and they want to buy it, no questions asked. So frustrating.

Jessica S.

I agree. This drives me insane.

Jennifer Nicole

Sounds like that can be great fun at their expense. Have some night shade, it’s all natural. =D Here’s a ghost pepper, it’ll clear all your toxins out by morning.

Irène Delse

Great post. I particularly like #3 and #5: it’s so easy to fall for the one-of-the-elect scam!

The Computer Ate My Nym

Yeah, who doesn’t want to be one of the elect?

http://kumquatwriter.wordpress.com/ Kq

These are also great flags for cult recruitment.

Emily

Great post, this describes my chiropractor.

The Bofa, Being of the Sofa

Ex-chiropractor, I’m hoping?

anion

Ever read all the chiro stories on Quackwatch? Definitely worth your time. I will never let another person fiddle about with my spine after reading it.

Young CC Prof

I saw a chiro some years ago, before I was a skeptic. At this point, I can recognize the classic signs. However, the one thing that drew me in was that, after a year and a half of tests and specialists and being dropped with the tests came up negative, he was the first person who acted like it mattered that I was in pain. Maybe if I’d had a family doctor more like Harriet Hall, I wouldn’t have fallen for him, but my family doctor had no time for me, so to the quack I went.

I wasn’t all the way in, though, and I drifted away from him, partly because it wasn’t working, partly because I knew that at least part of what he was selling was absolute bunk.

KarenJJ

That’s the very comforting part of quacks. I spent an hour going over my confusing symptoms with a Traditional Chinese Herbalist who listened with empathy and it helped me clarify what was going on and that it wasn’t silly. She also had some things to try. GPs had never gotten the full picture like that (and never had the time) and with my hodge-podge of symptoms quickly dismissed many as just a virus or something temporary that will pass. I felt that some of my concerns were legitimate.

Eventually I had a name for what was going on and took it to someone a doctor friend recommended. I spent an hour going over what was going on with a very senior Immunologist. He also listened to what was going on, did a few tests and had some ideas of things to try. It was also very reassuring, and much much more effective then what the TCM practitioner had me doing.

I can’t help but wonder how many people are seeing quacks who are in a similar position. If a few specialists were to go through the notes of a few quacks I wonder what they’d find?

One of my favorite quacky things I recently heard of. They think all diseases are psychologically based, and measles, for example, could be a manifestation of a kid being upset at being abandoned at daycare while mom and dad go to work. Swear to god I am not making this up.

PrimaryCareDoc

I hate stuff like this. It is “blame the victim” mentality at its worst. Take this, from the site (regarding the cause of metastatic breast cancer): “For example, the shock of having your breast amputated (a disfigurement conflict) can give you a skin cancer on the surgical scars, or a deep self-devaluation conflict (I am less than I was before) can cause bone cancer, the shock of the bone cancer diagnosis can give you a “death fright conflict” resulting in lung cancer because we believe that the cancer is spreading “like wildfire” throughout our body.”

Horrible. If you get metastatic breast cancer, it’s your own damn fault for getting “disfigured” by having a mastectomy.

Young CC Prof

I was engaging with an antivaxxer the other day, I told him he was victim-blaming and he actually said,

“Lifestyle has EVERYTHING to do with health. To ignore that is to rail against responsibilty. Take care of yourself. Take care of your family. Eat clean, exercise, hygiene, sleep. Stop being a victim. You know how to avoid “classic victim blaming”? Stop BEING a VICTIM.

99.9% of the time it IS the fault of the patient. Period. But keep being a victim, rail against responsibility, make horrible, intentional BAD health choices, and continue to blame everyone else for your own, self-inflicted health problems.”

PrimaryCareDoc

See, I think people really believe this stuff out of deep seated fear of the uncertainty of life. Anyone in the medical profession will tell you that shit happens. It just does. And there is usually nothing you could have done to prevent it.

The Bofa, Being of the Sofa

Ha. For many years, I have lived my life by the principle that, “Sometimes, shit happens for no reason at all.”

Young CC Prof

You know the Rush song “Roll the Bones?” A favorite of mine.

fiftyfifty1

No Bofa, It’s due to the flapping of butterfly wings. You know, fractals.

The Bofa, Being of the Sofa

I don’t think it is about a deep seated fear of uncertainty. I think it is out of a desire to be better then all of us weaklings. If you get sick and I don’t, and I can attribute to my “lifestyle,” then it proves that mine is better than yours.

Trixie

I do think it’s the fear of uncertainty. Or the desire for an explanation when things go wrong. I watched someone go through every bit of woo from detox foot pads to candida diet to Budwig protocol to acupuncture to try to stop ALS, a terrifying disease for which there is often no known cause, and no cure. When medicine can’t do much for you, it’s very tempting to seek alternatives.

Amy M

I think it is a bit of both—it’s sort of comforting to look at a sick person and say “Well, I’m not sick. It must be because I do x, y, z.” That makes it a lot easier to go to sleep at night than “anyone could get cancer at any time no matter what they do.” Of course, when you’ve been convincing yourself that you are doing everything “right” and then something bad happen anyway, it’s a pretty rude awakening.

Of course we’ve seen that kind of cognitive dissonance with homebirth disasters: “How could this have happened?! I did everything right!” It’s either “Well, you MUST have done something wrong, Mama” or “Some babies are meant to die.” Probably the same with cancer, I imagine–“It must have been that toxic thing my parents gave me when I was 6 and they didn’t know any better” or they get religious “It was meant to be.”

The Bofa, Being of the Sofa

Of course, when you’ve been convincing yourself that you are doing everything “right” and then something bad happen anyway, it’s a pretty rude awakening.

If that. They just transfer their blame to something else.

Consider Kim Stagliano. Her first two kids diagnosed with autism, and she jumped on the “vaccines cause autism” bandwagon, and was very public about it. So with her third, they didn’t vaccinate at all. Result? Also autistic.

Instead of sitting back and saying, hmmm, maybe it’s not the vaccines (the awakening), she doubled down. It’s not the kids’ vaccines that caused it, it is HER vaccines that she had throughout her life. It’s complete transference.

Personally, I don’t know how anyone can consider her to be any more than a joke. Someone so obviously biased in terms of the answer she wants. She even carried out the experiment, but couldn’t accept the results. How can she have any credibility at all?

Of course, she is the anecdote that proves the genetic origin, right? That’s a lot more consistent with her outcomes.

staceyjw

3 kids in a row with Autism? Damn, that is tough. I can see looking for a reason. I would feel bad for her, but I feel worse for those she is infecting with woo, and the kids at risk

Her and her husbands DNA ought to be studied. Doubt she would go for that!

Jacob Wrestled (Danielle G.)

That is primarily it. People want their suffering to have clear cause, and a remedy. But if not a remedy, at least it must have a story.

The Computer Ate My Nym

But will he still believe this when (and I do mean “when” not “if”) he gets sick?

The Computer Ate My Nym

Oh, never mind. I didn’t read carefully enough. I’m sure he’s part of the blameless 0.1%.

Jacob Wrestled (Danielle G.)

Yes, he will invoke the toxin theory. He is sick because his excellent habits were no match for the crafty purveyors of toxic food. He will believe he can get well by becoming even more stringent in his eating habits.

I love local / organic farms to death, but I saw this all the time back when I worked around food co-ops. People get sick, or their kids have problems, and they want it to “make sense.” And they want to have power over it. And they want it to have meaning. The toxin theory does this. So does a belief in multiple self-diagnosed allergies.

Jessica S.

The esthetician I go to for brow shaping is way into this stuff, talks about the balance of acidity/alkalinity and all the things it screws up if it’s wrong (I don’t listen closely enough to remember), and a myriad of other crap. It’s a good thing my eyes are closed half the time, I can’t suppress the eye rolls.

araikwao

Esthetician????! Is that what we used to call a beautician? Do they call it (a)esthetic school now? (Esthetic school dropout just doesn’t have the same ring to it..)

Jessica S.

I might be using the wrong word and/or spelling – someone who specializes in skin care and waxing, etc?

araikwao

You are far more likely to be right than me, seeing as I don’t have a beautician or esthetician. The term just seems akin to “garbologist”, etc

Bombshellrisa

It’s a lot like the book “You Can Heal Your Life”. It’s about how thoughts create disease and things like impaired vision or hearing. Everything from MS to cancer and varicose veins. If you have fat thighs, you are angry at your parents. Childhood illness is caused by tension in the family. It appeals to the idea that you can control what happens to you if you make a list of positive thoughts. Add some aromatherapy and a couple crystals and then some alternative therapy like tapping and you are over your head in the woo.

Alcharisi

Holy crap, do I detest that book (and others like it, but I have some direct familial experience with that one.) Not least because it’s framed in such a way that the victim-blaming is disguised. It gives you the promise of absolute control over your life in a warm, fuzzy wrapper, in a way that can sound EXTREMELY appealing to someone who’s going through a lot and feels as though they don’t have control over anything.
By the way, Barbara Eherenreich’s book “Bright Sided” is a delightfully caustic takedown of such hooey.

Bombshellrisa

I absolutely have to read that book now-thanks for the suggestion.
I had to deal with all sorts of well meaning but woo infested people during this last pregnancy. I did eat well (GD) and exercise but I had terrible prenatal depression. I shared this fact with a few people who couldn’t understand why I didn’t want to have a baby shower until after the baby was born and the suggestions would have been comical if it wasn’t me they were speaking too. GD was “caused by not finding any joy in being pregnant”. I am like a few people here, love love love my babies but being pregnant is just hell. My blood pressure creeping up was “unresolved anger”. Whatever. I couldn’t control either things if I tried, like Bofa said shit happens that is out of your control. Meanwhile I have gotten a lot of suggestions about post natal chiropractic to get my body in shape and tapping therapy and something called Landmark. I can’t imagine as a nurse telling my patient with complications of MS that they really are too needy and thinking needy thoughts has made them so sick so they guarantee they will get a lot of attention.

MB

Being pregnant is not nice, I completely agree. Hopefully I will get a healthy baby at the end of the journey but I am really envying my husband now! My breasts hurt, I am swollen, running a half marathon is out of question, I am nauseated most of the day and feeling very tired… It sucks! And you hear “enjoy your pregnancy” all around… It definetely sucks. My mother in law is worried that I do not gain enough weight and my mother is worried I am putting on too much weight. I am considering seriously taking up drinking for the first time in my life so that they can worry about something real and stop fussing about nothing.

Bombshellrisa

And people will either tell you look fabulous (which you certainly don’t feel a lot of the time) or that you look tired (even if you are feeling good).

The Bofa, Being of the Sofa

I will tell you that, I know you might not feel good or that you look good, but pregnant women really do look fabulous.

It’s a completely different perspective, I realize, but it’s true.

(I remember when my wife was pregnant and we were looking at t-shirts in Spencer gifts. The one I liked said “I’m not fat, I’m pregnant!” She felt that the “I’m fat because I’m pregnant” was more appropriate. As I said, it’s a completely different perspective – I don’t see pregnant women as “fat” (however, I can understand how they feel that way). And I really do think that they look fabulous!

Maria

Yep. Pregnancy was always “meh” for me. Not horrible, but not enjoyable either. I just smiled when people told me to “enjoy” my pregnancy or if they gave me unsolicited advice about how things were/should be going etc. Then I went about my day. I think the thing I found most annoying about pregnancy was that, as a person who doesn’t really enjoy being the center of attention, people paid way too much attention to me and my life!

Jessica S.

“I am considering seriously taking up drinking for the first time in my life so that they can worry about something real and stop fussing about nothing.”

Bahaha! I’m sorry, this is hysterical and I totally get it. I’m not laughing at your misfortune, I swear. I’m 33 wks preg and I never stop complaining about it.

MLE

Judging by my thighs, I’m so filled with rage against my parents that I’m thisclose to committing paternicide.

Yeah, it’s postpartum. I fell down the rabbit hole because a local wacky doula is offering special sacred baths on the 44th day after giving birth. Expand the product line beyond encapsulation, I guess. It’s called a Ceremonial Pregnancy Sealing Bath, and it’s $200!

Renee

Smart snakeoil salesman!

Trixie

My thing is, take the $200 and send mom to the day spa!

Renee

A fool and their money are soon separated.

Jessica S.

Now I crave fortune cookies.

The Bofa, Being of the Sofa

A fool and their money are soon separated.

…in bed.

Jessica S.

That is too perfect!

Renee

We need to send them to the Learner blog, so they can see what happens when quacks use massage on pregnant women’s bellies. Hint: it involves catastrophic rupture.
ETA_ its post partum. But since I can see some idiot thinking this would be great for a mom thats overdue, I will leave this here.

Guest Nurse

I am a PP nurse at a large area hospital. I *just* had a patient who had a Sacred Pregnancy Certified Mother Roaster come out to the hospital. I kid you not. She preformed a mother fear and trauma release ceremony.

Trixie

Wow, that’s nuts!

The Bofa, Being of the Sofa

I’ve said it before, sometimes, I think it is a shame that I have ethics. People are so easily parted from their money.

Jessica S.

NO SHIT. But I just couldn’t do it. It’s like, if you want to get rich, don’t *read* a book about how to get rich, write a book called Foolproof Ways to Get Rich in 30 Days, No Work Required. Or something.

Bombshellrisa

And then insist in the book that your thoughts have to be ones of prosperity and you will “attract” wealth.

Jessica S.

I was totally thinking of the Secret when I wrote that comment. I remember back when Oprah hyped that book. I watched one of the shows where they explained what it was about and at the end I was like, “um, did I miss something? B/c they literally said *nothing* but cozy words strung together to sort of form phrases.”

The Bofa, Being of the Sofa

I was thinking of the book Brian wrote on Family Guy where he left like half of the pages in the middle blank.

Young CC Prof

Step 1: Have faith in yourself.

Step 3: Achieve your dreams.

I guess they forgot Step 2.

Mishimoo

Step 2 is a secret

Amy M

Step 2 was steal underwear, wasn’t it? Or was that step 1?

Jessica S.

Hahaha! That’s exactly right! And of course, Step 4 for those particular authors was: Go on Oprah, you’re set for the rest of your life.

MLE

Some coworkers of mine were discussing the secret and were shocked to hear my normally wet blanket self state that I do believe in the power of positive thinking, meaning that if you’re thinking positively you’re more likely to take action on your plans, etc. They took this as an endorsement of the secret itself and started buying lots of lottery tickets

fiftyfifty1

But you’ve also said many times that charlatans need to be charming and likeable to succeed.

Roaster?? What does that mean other than cooking with some fat via an indirect heat source?? Oh no, I’m gonna have to look at this link…better get out the tin foil to wrap around my head first..

araikwao

Mind boggled…

http://Www.awaitingjuno.blogspot.com/ Mrs. W

You’re missing the “Variation of Normal” flag…after all you don’t have a problem if its just normal, so then you don’t need to do anything about it.

Therese

I disagree with the toxins being a figment of the imagination. When crunchies talk about “toxins” they are talking about things like pesticides, mercury, formaldehyde, arsenic, etc All real things and all things that are toxic in high enough doses. So rather than saying that those things don’t exist, when they obviously do, wouldn’t it be better to focus on the whole argument about the dose makes the poison? I just don’t understand if someone is worried about formaldehyde in vaccines, how telling them it is a figment of their imagination is going to win anyone over to our side.

Young CC Prof

True. Some toxins are real. However, one good heuristic is to be suspicious of anyone who warns about toxins without telling you what the toxins are!

So, ask “What toxins and in what quantities?”

Mariana Baca

Dose is one aspect, but the other aspect is the aspect of needing to “Detox” or “flush toxins” to get rid of accumulations of bad things. With the exception of things like heavy metals, the body does a good job at regularly getting rid of bad things we ingest in small amounts. They don’t needlessly accumulate and need to be detoxed.

Therese

What about different chemicals like PBDEs (fire retardant chemicals) that have been found to accumulate in humans? Not that I think there is any reliable method of detoxing from these things, but I understand why it disturbs people that these “toxins” are accumulating in their bodies.

Mariana Baca

I mean more like things like a “Master Cleanse” or a sweat lodge to get rid of toxins in the bowel or skin. I guess it can clear out a bowel impaction or some zits, maybe, but that is about it.

The Bofa, Being of the Sofa

And if someone actually expresses concern about PBDEs, then we can discuss it. For example, we can talk about the effects of PBDE accumulation.

But that’s not what people who bring up “toxins” are generally referring to. They are referring to a vague concept of bad things that cause all kinds of problems. Specifically, the problem you are having.

That’s the point of YCCP’s comment below. If you are concerned about PBDE toxicity, you talk about it. People who bring up “toxins” are not addressing anything in particular, just basically as Dr Amy says, invoking the “unseen” stuff to blame.

Therese

I don’t know, PBDEs aren’t the only chemical out there like that. Rather than list 20 different chemicals and heavy metals by name, they want to use one name, so the crunchy community has settled on “toxin”. Then I suppose there are a lot of not so educated people, who just pick up on the toxin talk and run with it with only having the vaguest idea or maybe none at all of what toxins they are talking about, but I still think the original toxin concerns were all based on actual toxins.

The Bofa, Being of the Sofa

still think the original toxin concerns were all based on actual toxins.

I don’t. I think they are the modern equivalent of humours. Undetectable things that are blamed for whatever problems.

People have been blaming their problems on the undetectable thingies long before the modern era of environmental toxins. We don’t need anything real to explain it.

fiftyfifty1

“but I still think the original toxin concerns were all based on actual toxins.”

I see your point. At the same time I am amused that I see plenty of parents who are concerned about “toxins” but none of them seem concerned about lead which is actually a potential concern in the gentrified (or sometimes not yet gentrified) neighborhoods they come from.

S

A friend of mine became somewhat toxin obsessed after lead exposure at her workplace, immediately followed by an issue with mold in their home causing illness. She was pregnant with small children at the time, and she had to take legal action to get these issues addressed. I can understand why she’s swung over to the side of near paranoia, but it’s hard to watch.

Spamamander

I know you’re saying that the lady was pregnant as well as having small children, but it read to me like she was pregnant with small children… poor woman is carrying around preschoolers in there!

NoLongerCrunching

Funny how they’re so quick to use actual toxins like colloidal silver…

I guess its like the old saying about porn: You cannot define it, but you know it when you see it.
Specific questions or concerns over particular chemicals are not the same as the gambit of “toxins”.

The Bofa, Being of the Sofa

Listen to a toxicologist talk about toxins. It’s always very specific about what is causing the problem, not just some category of whatever.

Stacy48918

The dose makes the poison.

Even water can kill you if you drink enough of it at once. Clients bring me pets all the time that have ingested “toxins” – chocolate, brodifacoum, bromethalin, ibuprofen, etc. if the mg/kg dose is low though it’s emesis and have a nice life. Bit more complicated if they consumed a potentially lethal dose.

I am not worried about minute clinically irrelevant levels of “toxins”. It is the quacks’ complete lack of understanding of toxicology that makes them say “toxins” are bad.

The Bofa, Being of the Sofa

Even water can kill you if you drink enough of it at once. Clients bring me pets all the time that have ingested “toxins” – chocolate, brodifacoum, bromethalin, ibuprofen, etc. if the mg/kg dose is low though it’s emesis and have a nice life.

Did I ever tell you about the time our 12 kg pup got into and ate up the 1/4 lb of chocolate fudge that I had gotten my wife for Valentine’s Day?

Fortunately, it was milk chocolate, but it still hit him hard. Pretty lethargic for a couple of days, and puking chocolate all over the carpet.

Dr. Mrs. Bofa, DVM, was PISSED

Stacy48918

“There’s an app for that.”
A couple vets designed a chocolate toxicity app (ChocTox) for iPod/etc that automatically calculates mg/kg dose and tells you what clinical signs to expect. Looks like your guy got 21.3mg/kg. Expect MILD signs
Very handy when folks call in the middle of the night.

Jessica S.

Are there other animals that will get sick from eating chocolate? Like cats?

Mariana Baca

Cats get sick from eating chocolate, too, but I think they are less likely too, since as a general rule can’t taste sweet things. Depends on the cat, but my cat isn’t interested at all.

http://whatismyreferer.com/ MikoT

“toxins” – chocolate, brodifacoum, bromethalin, ibuprofen
Just to nitpick – those are toxicants.
Toxins are naturally occurring toxic substances as opposed to toxicants which are man made.

Stacy48918

Thanks for the clarification. I know how to treat specific intoxications…but toxicology still wasn’t my fav class.
Though I would wager that NCB/quacks don’t make any difference either – something manmade or naturally occurring would likely all be lumped in as “toxins” to them.

Irène Delse

Figment of imagination is a bit over the top, but when I hear people complaining about vaguely defined toxins, blame everything related to modern life (“processed food”, conventional agriculture, cleaning products, medicines…) and then worship nature as if there were no poisons there… Sorry, that’s an alternate reality version of the world right there. Shame it’s so pervasive.

Are you nuts

Both you and Therese make good points. When I read this, I thought of the people who make claims like, “I don’t eat ingredients I can’t pronounce.” Well… unless you’re eating nothing but water and table salt, I guarantee you’re eating ingredients you can’t pronounce (or at least they sound scary even if you can pronounce them).

The Bofa, Being of the Sofa

I’m a chemist. I have no problems pronouncing chemical names and none of them sound scary to me.

But I get your point.

I’ve mentioned in the past the commercial I remember for Breyer’s ice cream, where someone is reading the ingredients list from some other ice cream. The one I remember is carrageenan. Actually, if you look into what it does, it makes sense that it would be used ice cream (it’s for creating good gels, so it makes your ice cream smooth).

Now, wikipedia talks about questionable health effects, I will just point out that carrageenan comes from edible seaweed, so it is 100% natural…

NoLongerCrunching

Unfortunately Breyers has moved so far away from being ice cream that they’re now required to call it “frozen dairy dessert.” Back in the day it was really good.

Joy

Turkey Hill makes an all natural line now.

Trixie

I just have to laugh because I grew up very near Turkey Hill Dairy’s actual original dairy farm (the ice cream brand has since been sold to Kroger).

The dairy’s on top of a landfill. Just like nature intended!

Mac Sherbert

How often do you see people raising crops just outside of plants!? Where I live you see it and my husband knows what chems are used in these plants. When I asked him how safe that was he just kinda of shrugged like its all relative.

He actually said everyone has one of those chems in them right now…it can even be found in the Arctic. I thought wow I’m sure that info would really freak out the all organic folks.

If this entire comment flew over your head: re-read that last sentence, and try it.

Mariana Baca

The “Big Pharma” conspiracy amuses me. All Pharmaceutical companies are in competition. They don’t want to give each other an edge. If they can do something better and cheaper than someone else, and patents don’t stop them, they will. They aren’t in cahoots — they want to outsell each other.

Paloma

Also, everyone is so afraid of pharmaceuticals, when really every industry on the planet wants to sell more and make more money. Siemens and Phillips make MRI machines, do you really think they don’t try to convince you theirs is better than their competitor’s? Same goes for things like food, clothing, and every other thing sold. And nobody thinks those companies are trying to conspire against humanity…

The Bofa, Being of the Sofa

And nobody thinks those companies are trying to conspire against humanity…

Make no mistake, there are those who do. Look at formula, for example.

LOVE the Woo-O-Meter! The spreading of Woo is one of my hugest pet peeves, to put it mildly. I appreciate your example especially, as my husband has ADHD and also works in the public schools, with many children who have it. He loves to help people learn how to cope with it, by teaching them various (non-medical) strategies. One thing we both hate to see is quacks trying to take advantage of parents who are struggling to help their children.

Last year, some quacks, very much like the ones in your example, came to our public library, peddling “muscle-testing” to determine which micronutrient was deficient and causing the ADHD. Yeah. And then of course, selling, said micronutrient to you, and maybe even involving you in their pyramid scheme of “natural supplement” sales. Boy was I pissed…I wrote to the library, and asked if they were aware of the bogus crap they were selling. They wrote back, and they didn’t seem to realize it was quackery, yet they booked these people for another couple of visits. Of course, we have freedom of speech here, but I made it clear (using my freedom of speech) that I thought it was appalling that a library, a place where people go to gain knowledge, was sponsoring such bs.

In an effort to promote reality, my husband asked the library if he could give a presentation about ADHD and he would talk about his non-medical strategies (which involve things like using timers, breaking tasks into manageable chunks, gaining better understanding of the maturity level of a child with ADHD, making sure children with ADHD get proper sleep and exercise, and non-quacky things like that.). They let him do that, but I don’t know how many people attended both presentations, or if they did, realized the quacks were quacks.

Ainsley Nicholson

I would really like to learn more about these non-medical strategies to manage ADHD; my older 3 kids all have ADHD type behavior (2 are inattentive, one is hyperactive). Stimulant medication was a disaster for my daughter, and my subsequent reading of the medical literature brought me to the conclusion that stimulant medication has no long-term benefit but definate possibilities for long-term harm. But I keep trying to find SOMETHING to help them.

Mariana Baca

” stimulant medication has no long-term benefit”

It is not a cure, it is a treatment, like insulin for diabetes. There are long-term problems with untreated ADHD, though — long term self-esteem issues leading to depression and inability to learn coping strategies can be more serious than physical side effects from stimulant medication.If stimulants are ill tolerated, there are non-stimulant medications, too (and some medications that re not approved for kids but will work for adults, like provigil and wellbutrin). That said, a combo of meds and CBT/time management hacks can be helpful for many individuals.

Jessica S.

“long term self-esteem issues leading to depression and inability to learn coping strategies can be more serious than physical side effects from stimulant medication.” I’ll second this!

Amy M

Sure–If you have ADHD kids, you’ve probably heard a lot of it, but I would be happy to put you in touch with my husband. Or if that’s a little uncomfortable for you (he has a lot of practical experience, and is about to complete a guidance counselor degree, but he is not a neuropsychologist/psychiatrist), can you find a neuropsych who specializes in children with ADHD? Both my husband and I learned a lot from a clinical neuropsych we know….first thing to keep in mind (for example) is that children with ADHD are generally operating at the maturity level 2-3yrs below their actual age, and that’s the best they can do. After that, timers can be your best friend…start there.

Also, just to say, my husband has been on stimulant meds himself and found them helpful, and uses the non-medical strategies in conjunction with meds, not necessarily in lieu of them. He has no medical jurisdiction at all, and would NEVER attempt to give medical advice to anyone, but he will offer complementary strategies that anyone can try, whether or not there are meds involved.

Mer

Amy, I have ADHD myself, along with my oldest son. If your husband wouldn’t mind I would really appreciate any strategies he could share. For both myself and my son. We are currently working on getting meds started for my son (he’s 15 and thought he might join the military so we waited a bit but he just has too many problems without it so we’re going ahead with meds) and working on getting an official diagnosis for myself. I’m currently breastfeeding so no meds for me right now and I could really use all the help I can get to manage myself and my son. My email is lionessong at hotmail Thank you!
On a side note, my oldest doesn’t get along very well with his father right now and that’s why I’m the one trying to manage him. Now if someone would just manage me!

Ainsley Nicholson

I would be delighted to get your husband’s advice (it is easy to find me on facebook).

Amy M

Ok, I will look for you there.

Jessica S.

My husband has ADHD (inattentive type) and he purposely takes the regular, non-extended release amphetamine salts so he can have better control over taking it just when he needs it. I actually switched to it after awhile, too!

A side story, I was already diagnosed with ADHD when we got married, he had not been. One day he read a story about a baseball player with ADHD and something clicked in his brain and he realized this explained some much of himself. He came out to living room, where I was sitting, and said “I think I have ADHD.*” I burst into tears, wailing “But you’re supposed to be the SANE one in this marriage!!” In reality, I think it’s brought us closer. If anything, it’s good for a lot of laughs.

*He did go in for a formal evaluation and in fact did have the inattentive type and has responded well to meds. It made a huge, positive difference in his career!

Renee

Stimulants do have long term benefits- they allow the person with ADHD to succeed, educationally and socially, instead of being constantly frustrated, irritated, annoying to others, barely making it through school or work.

Had I had access to them sooner, I would have saved myself a lot of misery. There is nothing like being smart and capable enough to get a 4.0, but only being able to manage a 2.0, with behavior and discipline issues, without meds.

I agree there are downsides. But the downside of a life of failure may actually be worse. If you control for addiction, I think its worth it.

(and I LOATHE stimulants. Loathe them. Sadly, its the only thing that works. Strategies only go so far, which is not enough.)

Young CC Prof

For some people, the stimulants just don’t help, or they interfere with sleep too much or otherwise make brain function worse. However, if they are working, it’s often worth some physical side effects, especially if your child is miserable in school every day without it. I wish I’d been diagnosed and medicated at, say, seven. I regard those years the same way I do my knee injury without pain management: I got through it, but it sucked, and I really wish I hadn’t needed to.

But yes, there are non-drug options. It begins with the principle of proper standards: Your child must have standards and expectations, and they must rise over time, but they also need to be based on his or her actual abilities right now, NOT what the “average” kid that age can do.

Your ADHD seven year old might be reading at a fifth-grade level, but be functioning at a 4-year-old level when it comes to discipline and executive function. One trick is to give ONE task, then another one when the first one is finished. Make eye contact and ensure child is engaged before starting the instructions.

Jessica S.

I wish I would have been diagnosed at a younger age, too. I’ve come to the conclusion, through lots of reflection, that by the time I was diagnosed at 13, it was way too late. The damage to my self-confidence and self-image was significant and that’s a hard bell to un-ring. Plus, my parents were at the beginning of a very long, bitter, roller-coaster, agonizing and, frankly, complete self-absorbed separation and divorce – right around the same time I was diagnosed so everything was chaotic at home and inside me, too. I don’t think any medication could’ve overcome those extenuating circumstances.

I’m 37 and I still suffer from negative “self-talk”, low self-esteem, etc. It sucks. Also, I have a really hard time finding books about parents who have ADHD, and how it impacts their lives as parents. That’s frustrating to me. There has to be more women out there with ADHD that feel like they’re swimming upstream. I’m totally freaked out about having a second kid in a month and a half. I don’t know how I’m going to manage both with melting down. Daily.

Young CC Prof

Thirteen is a really bad age, period. And no, the ADHD never goes away. If you’re lucky, you find a niche on Planet Earth where it doesn’t interfere too much.

You’ve read, “You mean I’m not lazy, crazy or stupid,” right? That’s a classic, although a bit old now.

I don’t like stimulants, too much up and down, too much sleep disruption. I actually did really well on SSRIs, until I had to quit due to physical side effects (which is uncommon.)

Jessica S.

I’ve never understood the logic behind ADHD not extending into adulthood. That doesn’t mean it’s not true, certainly something doesn’t have to make sense to me in order for it to be true. Maybe when it is diagnosed and treatment is kept up, it doesn’t have as negative an impact as an adult? I honestly don’t know. You’d think it’d be something I’d researched by now, but by nature of the ADHD, reading is a struggle. Or at least, staying interested long enough.

Stimulants have done wonders for me, but there are trade offs. Sometimes I’m more “intense” on my meds, but that may be an indication that my dose should be a little lower in social situations. “Intense” isn’t a factor if I need to focus on a solo task. (This is why I prefer the standard tabs to the extended release capsules – I can modify the dose easier when I know each dose will wear off approx 4-5 hours later.) If I’m having a hard time getting to sleep at a decent hour, I’ve found taking a lower dose (like half of what I’d take in the morning and at noon) around 5pm actually helps me sleep at night. But it has to be low and no later than 4 hours before I want to climb into bed. After a week or so of doing that, I can usually establish enough of a habit that I don’t need the meds at night. Then I’ll fall off the wagon and lather, rinse, repeat.

I haven’t read that book but I’ve heard great things about it. I should check it out from the library!

Young CC Prof

It does extend into adulthood, BUT some people learn to manage it better. Our executive function is delayed, but delay isn’t stasis.

Also, in our society, adulthood is in some ways more flexible than middle childhood. You can choose a career that plays to your strengths, rather than having to attend a school that seems especially designed to play to your weaknesses, for example. You can build systems to help you do what you need to do.

Still, it’s a question of learning to deal. Some adults learn to deal very well and only occasionally have disruptive problems, some haven’t yet. The essential brain difference doesn’t just disappear with time.

Jessica S.

Great points. There’s something to be said about adulthood and the experience it brings. I may have been negatively impacted by low self-esteem as a child, but at least now I can look back and see how much if it (pretty much all of it!) was bullshit stuff that shouldn’t have been taken personally. There’s good growth in that!

Ainsley Nicholson

I’m glad they work for you, and I don’t dispute that they have some significant short-term benefits. In my daughter’s case, she ended up kinda psychotic after being on them for three years…it is difficult to imagine any long-term benefits that would be worth the kind of mental and behavioral changes that her meds caused. Thankfully her mental equilibrium returned quickly after discontinuing her meds.

fiftyfifty1

It really is tough when prescribed stimulants cause psychosis. It’s rare but it happens. I remember when that happened to a patient of mine. Luckily, stimulants are out of your system completely with a couple of days, so the psychosis goes away quickly (unless it really isn’t due to the stimulant but rather due to a true developing mental illness). It sometimes happens on Prednisone too. Not pretty, but once again short lived if you recognize the problem and stop the med.

Were they actually diagnosed with ADHD, though? Because from what I’ve read, that can be an issue: if you give ADHD meds to someone that has another sort of issue, it likely won’t help! The Pediatric Insider blog recently did a post cautioning on the risk of incorrectly identifying hyperactivity and attention deficit troubles.

Ainsley Nicholson

Yes, two of the three have been officially diagnosed with ADHD. The third has not only because I have not sought a diagnosis for him, but I’ve had many conversations with his teachers about his attention troubles, and they are just as bad as his siblings.

Mac Sherbert

As a (former) special ed. teacher I can tell you there are things that can be done to help. I know it’s not easy, but you care and you can help your children learn to recognize their own behaviors. Someone mentioned a timer!!! That does help a lot! There are also some special seats you can put in the chairs that help with the hyper-part.

I think rather than looking for a magic herb, your best bet would be to look into behavior modification techniques for children with ADD and ADHD. It will take patience and a lot of work, but that doesn’t mean they can’t improve. Also, remember lots of kids are hyper. It doesn’t mean it’s a character problem…just normally an environment problem when it comes to school.

Trixie

Oh geez, muscle testing. I was on a forum with someone whose chiro did muscle testing and found that her kid was allergic to all sorts of things, including vinegar. And she fed him some weird organic vegan diet on top of that. And was so proud that he was still tiny enough to rear-face at age 6.

Amy M

Ugh, that’s awful.

fiftyfifty1

This is a huge problem for my patients with eating disorders. So many of them come in with “diagnoses” of food allergies from their alternative practitioners. It gives them false validation for all the restrictions and “food rules” that they have put on themselves. It makes me sick.

Trixie

Yeah. Even worse when people apply orthorexia to their kids. He was homeschooled, too, so as never to not be under her control.

KarenJJ

I just looked up orthorexia as I didn’t know what it meant. I’m glad they’ve got a name for it and it’s a recognised thing.

Jessica S.

Have ever heard of or used the Time Timer? It’s the most ridiculously simple idea but it’s been indispensable to us for helping our son understand how much longer he has until something or left of something, etc. What I didn’t expect was how much *I* would like it. I have ADHD, too and it’s so much easier for me to visualize how much time I have left. http://www.timetimer.com

Amy M

Yep! We have a big ol’ plastic one, and husband has the app on his smart phone.

Jessica S.

Me too! I love that I can say “sorry, the red is gone” and 75% of the time (and that’s a great percentage for a three and a half year old) my son will stop arguing, as if it’s some mystical time piece that shall never be questioned. Unlike mom or dad, who are questionable, indeed. Obviously you could get the same effect from a kitchen timer, but there’s something about the red. I think it’s also helped him learn to recognize double digit numbers, to a certain extent.

Amy M

The only issue I have with it is the beep isn’t very loud, which is why we use kitchen timers more often. My boys respect timers though, so far anyway. We use them to control iPad use a lot. Sometimes they grumble about having to stop playing, but they stop.

The Computer Ate My Nym

Love it, but just to add a note of caution: I put in the values for the original Wakefield Lancet paper and got a value in the “true” range (based on information available at the time, not including things that came out later, such as Wakefield’s COI.) So remember that even good journals can be fooled and the ultimate tests are reproducibility, a plausible mechanism, and good placebo controlled trials.

NoLongerCrunching

Did you alert them?

Marni Nicholas, MD

Excellent caveat!

Renee

Easy to add “any thing with Andrew Wakefield is woo”
and solve that

alannah

Reproducibility, a plausible mechanism and good quality trials you say. ….. well, there goes 99% of the existing literature on the benefits of breastfeeding.

Mel

I’d like to add mis-use of the ideas of evolution to “quantum” flag.

As I lectured to my HS kiddos yesterday,evolution is the change in the frequencies of alleles in a population over time. You can’t describe a single individual as ‘more evolved’. Plus, as we demonstrated in the Siberian Tiger activity*, just because the parents had good visible traits doesn’t mean the cubs don’t have a lethal combination.

This is a critical point to consider for home birth: Just because you are descended from women who gave birth to infants that survived doesn’t mean that you are not going to have massive or fatal problems during childbirth.

( *Siberian Tiger Activity: Students model a gene pool of black beads – dominant alleles that give a cub hair – and white beads – recessive bald tiger cub. Double recessive cubs die during the first cold snap, so their genes don’t make it back into the gene pool (a paper bag) from which we draw pairs of beads for cubs of the next generation. Over time, the relative frequency of black beads to white beads gets much higher, but that same increased frequency of black beads increases the number of carriers – one white + one black bead. In short, after 5 generations of no hairless cubs, a bald cub can pop up again.)

The Computer Ate My Nym

Hi, I’m a bald Siberian tiger. That is, an Rh- child of Rh+ parents with 4 Rh+ grandparents. Further back, I couldn’t say. Rhogam for the subversion of genetic destiny, in my case.

Irène Delse

Oh yes, seconded on evolution! It’s used to justify whatever is trendy, be it in diets, parenting or even management!

ETA: Great job with the Siberian Tiger thing. I’d have loved that as a kid.

KarenJJ

And sometimes genes just randomly mutate for no particular reason. One of my recent ancestors had an “A” swapped with a “T” or something and now a protein no longer folds correctly and it causes all sorts of issues from an over-active immune system. It is a dominant inheritance so this issue has hit a lot of family members.

I’ve no idea how anyone would be able to stop these types of mutations and I don’t know that we’d want to. That hasn’t stopped people from trying to guess – eg one person suggested my grandmother ate yeast and that affected the genes…

Young CC Prof

The DNA replication process normally makes about one error in 10^7 operations. In the absence of any mutagen.

The price of flexibility is the occasional nonviable organism. Nature sucks.

fiftyfifty1

“Just because you are descended from women who gave birth to infants that survived doesn’t mean that you are not going to have massive or fatal problems during childbirth.”

Exactly. As Charles Darwin pointed out, the way evolution works is that individuals are always producing way more offspring than are likely to survive, and those that aren’t fitted to the moment (and on top of that lucky) don’t.

*Or do I mean discreet? Actually, either works in a twisted sort of way.

Mel

At my first teaching job, the principal created very effective fraud in which he reported a student count of over 600 students when we had under 200 students.

How did it all unravel? A teenage graduate of the program was hired as a secretary. She told her dad about what she was doing at work – essentially she was changing written attendance records and forging signatures, but she didn’t understand that at first. Her dad recognized the illegal nature of what she was doing and had her call the police.

Since that fiasco, I’ve become even less ready to believe in conspiracy theories since I’ve seen how a single person can bring the whole thing crashing down without any malice intent.

Young CC Prof

As I tell my students, discreet means keeping it on the down low. Your average academic scientist finds it almost impossible to keep things discreet, unless required to do so, and even then they’re bursting at the seams until publication day arrives.

Discrete is like quantum. Individual and separated. Scientists aren’t that, either, they don’t live in ivory towers, they have parents, children, spouses, old school buddies. No man is an island, not even the evil medical researchers.

Mariana Baca

OTOH, Discrete also means non-continuous, not necessarily isolated, though. Scientists are discrete — they aren’t an amorphous blob that agrees on everything.

Young CC Prof

I especially like #4 and #6. Toxin, quantum, epigenetic, and microbiome are absolutely quack key words. Quantum means a discrete unit, people. As in one photon of light, or one molecule of a chemical. It doesn’t mean magic works.

Amy M

Toxin is my favorite! I always want to know which toxin exactly, and why is it toxic?

Young CC Prof

And of course, HOW MUCH of this “toxin” is there?

Amy Tuteur, MD

Dr. Amy Tuteur is an obstetrician gynecologist. She received her undergraduate degree from Harvard College in 1979 and her medical degree from Boston University School of Medicine in 1984. Dr. Tuteur is a former clinical instructor at Harvard Medical School. She left the practice of medicine to raise her four children. Her book, How Your Baby Is Born, an illustrated guide to pregnancy, labor and delivery was published by Ziff-Davis Press in 1994. She can be reached at DrAmy5 at aol dot com...
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